Delavari Sarina, Megas Ioannis-Fivos, Billner Moritz, Reichert Bert, Breidung David
From the Department of Plastic, Reconstructive and Hand Surgery, Center for Severe Burn Injuries, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany.
Department of General and Visceral Surgery, Hospital Martha-Maria, Nuremberg, Germany.
Plast Reconstr Surg Glob Open. 2024 Jul 19;12(7):e5981. doi: 10.1097/GOX.0000000000005981. eCollection 2024 Jul.
This report presents a case of necrotizing fasciitis following a seemingly minor injury sustained from handling a spiny plant. Despite initial primary care by a physician, the patient presented with severe septic shock and necrotizing fasciitis of the hand, necessitating emergency surgical intervention. The use of scoring systems aided in the prompt recognition of the condition. Subsequent surgery was required due to infection progression, leading to significant soft tissue defects and functional impairment. The patient underwent multiple reconstructive procedures, including placement of dermis-replacement material and, ultimately, free flap reconstruction, to restore the hand function. This case report highlights the importance of rapid identification of potential cases of necrotizing fasciitis in cases of hand infections, demonstrates that scoring systems can assist in smaller affected body sites such as the hand, and illustrates the difficulties of defect reconstruction following necrotizing fasciitis.
本报告介绍了一例因接触多刺植物而受到看似轻微的损伤后发生坏死性筋膜炎的病例。尽管最初由医生进行了初级护理，但患者仍出现了严重的感染性休克和手部坏死性筋膜炎，需要进行紧急手术干预。评分系统的使用有助于及时识别病情。由于感染进展，随后需要进行手术，导致严重的软组织缺损和功能障碍。患者接受了多次重建手术，包括植入真皮替代材料，最终进行了游离皮瓣重建，以恢复手部功能。本病例报告强调了在手部感染病例中快速识别坏死性筋膜炎潜在病例的重要性，表明评分系统可有助于较小的受影响身体部位如手部，并且说明了坏死性筋膜炎后缺损重建的困难。
