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坏死性筋膜炎的临床表现及治疗结果:索科托儿童与成人的前瞻性对比研究

Clinical Presentation and Treatment Outcomes of Necrotizing Fasciitis: A Prospective Comparative Study of Children and Adults in Sokoto.

作者信息

Alasi Mustapha Adeyinka, Aqyil Nazish Perveen, Oyeleke Akeem, Yahaya Mohammed, Taiwo Abdurrazaq Olanrewaju, Legbo Jacob Ndas

机构信息

Department of Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.

Department of Medical Microbiology and Parasitology, Faculty of Basic Clinical Sciences, Usmanu Danfodiyo University, Usmanu Danfodiyo University Hospital, Sokoto, Nigeria.

出版信息

J West Afr Coll Surg. 2025 Jan-Mar;15(1):59-67. doi: 10.4103/jwas.jwas_183_23. Epub 2024 Jul 18.

Abstract

BACKGROUND

Necrotizing fasciitis (NF) is a severe soft tissue infection typified by swiftly spreading necrosis of the fascia and subcutaneous fat with successive necrosis of the skin which affects all age groups.

OBJECTIVE

To compare the clinical presentation and treatment outcome of NF between children and adults.

MATERIALS AND METHODS

A prospective descriptive study of all patients presenting with NF to the (Usmanu Danfodiyo Univrersity Teaching Hospital, Sokoto), from September 2018 to August 2019. Participants were stratified into adults and children for comparison during data analysis.

RESULTS

A total of 32 patients were analyzed, 24 (75.0%) were adults. The age range was 2 weeks to 75 years with a median age of 35 years. Necrotic skin patches and skin erythema were the most common cutaneous findings. The lower limb was the most commonly affected region in adults (58.3%), whereas the head and neck and abdominal wall were equally commonly involved in children (37.5%). Children had more multiple isolates than adults, 87.5% compared to 62.5%, respectively, and it was significant ( value 0.04). and species were both significantly commoner in isolates of children than adults ( value 0.01 and 0.04, respectively). The method of wound coverage was significantly different ( value 0.003) as fewer children required skin grafting. The mortality rate was 6.25%, the two deaths occurred in adults.

CONCLUSION

NF is commoner in adults in our region. The predilection sites of the disease in the two groups differ and healing by secondary intention was more possible in children.

摘要

背景

坏死性筋膜炎(NF)是一种严重的软组织感染,其典型特征是筋膜和皮下脂肪迅速蔓延的坏死,并伴有皮肤的相继坏死,可影响所有年龄组。

目的

比较儿童和成人坏死性筋膜炎的临床表现和治疗结果。

材料与方法

对2018年9月至2019年8月在(索科托乌斯曼努·丹福迪奥大学教学医院)就诊的所有坏死性筋膜炎患者进行前瞻性描述性研究。在数据分析过程中,将参与者分为成人和儿童进行比较。

结果

共分析了32例患者,其中24例(75.0%)为成人。年龄范围为2周至75岁,中位年龄为35岁。坏死皮肤斑块和皮肤红斑是最常见的皮肤表现。下肢是成人中最常受累的部位(58.3%),而儿童中头颈部和腹壁受累的比例相同(37.5%)。儿童的多重分离株比成人多,分别为87.5%和62.5%,差异有统计学意义(P值0.04)。儿童分离株中A组链球菌和金黄色葡萄球菌均显著多于成人(P值分别为0.01和0.04)。伤口覆盖方法有显著差异(P值0.003),因为需要植皮的儿童较少。死亡率为6.25%,两例死亡均发生在成人中。

结论

在我们地区,坏死性筋膜炎在成人中更为常见。两组疾病的好发部位不同,儿童更有可能通过二期愈合。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b300/11676017/e134e11cd51f/JWACS-15-59-g001.jpg

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