Piette E, Ungerer L, Roulot A, Walhin N, Leymarie N, Romano G
Département de chirurgie plastique oncologique et reconstructrice, institut Gustave-Roussy, Paris, France.
Département de chirurgie plastique oncologique et reconstructrice, institut Gustave-Roussy, Paris, France.
Ann Chir Plast Esthet. 2024 Sep;69(5):457-464. doi: 10.1016/j.anplas.2024.06.008. Epub 2024 Jul 14.
Necrotizing fasciitis is a rapidly progressive soft tissue infection extending from the skin to the fascia, resulting in extensive necrosis. It is a very rare but serious complication, with mortality ranging from 10 to 15%. Optimal management involves early diagnosis followed by treatment combining antibiotic therapy and wide surgical removal as soon as possible. Localisation in the breast is uncommon. Although most cases are primary necrotizing fasciitis of the breast, several cases of necrotizing fasciitis have been reported in the post-operative aftermath of breast surgery. We present a case of necrotizing fasciitis of the breast following submammary mastectomy with immediate reconstruction using a pre-pectoral silicone implant, which resulted in multiple organ failure and the death of the patient despite optimal medical and surgical management. This is the first case to occur after immediate breast reconstruction.
坏死性筋膜炎是一种从皮肤延伸至筋膜的快速进展性软组织感染，可导致广泛坏死。它是一种非常罕见但严重的并发症，死亡率在10%至15%之间。最佳治疗方法是早期诊断，随后尽快联合抗生素治疗和广泛手术切除进行治疗。乳腺部位的坏死性筋膜炎并不常见。虽然大多数病例是乳腺原发性坏死性筋膜炎，但也有几例在乳腺手术后的术后阶段发生坏死性筋膜炎的报道。我们报告一例乳房下乳房切除术后立即使用胸肌前硅胶植入物进行重建后发生的乳腺坏死性筋膜炎病例，尽管进行了最佳的医疗和手术管理，但仍导致多器官功能衰竭和患者死亡。这是即刻乳房重建后发生的首例病例。
