Adant J P, Bluth F, Fissette J
Department of Plastic Surgery, University Hospital Sart Tilman, Liège, Belgium.
Acta Chir Belg. 1998 Jun;98(3):102-6.
Necrotizing fasciitis is a rapidly progressing, synergistic bacterial infection of fascia with a reported average mortality of about 40%. Fournier's disease, necrotizing fasciitis of the genital sphere, is also included in this study. Seven patients were studied over a one-year period between May 1991 and October 1992. Most commonly, they were infected by perineal diseases, medical procedures and cutaneous ulcers. The local clinical signs are cellulitis, oedema, blisters, necrosis and crepitus; general septic symptoms may also be present. Associated chronic diseases were present in 4 patients. Three infections were polymicrobial. Control of this potentially lethal soft-tissue infection is based on early clinical diagnosis, timely, wide surgical debridements and appropriate antibiotic treatment. The overall mortality rate was 1 of 7 (14%). Death was due to persistent wound sepsis and systemic septic complications, but mainly to delay in surgical treatment. The presence of chronic debilitating diseases (diabetes, alcohol abuse, renal insufficiency, ...) contribute to increase rate of both local and systemic infection.
坏死性筋膜炎是一种进展迅速的筋膜协同性细菌感染，据报道平均死亡率约为40%。本研究还包括福尼尔氏病，即生殖器部位的坏死性筋膜炎。在1991年5月至1992年10月的一年时间里，对7例患者进行了研究。最常见的感染途径是会阴部疾病、医疗操作和皮肤溃疡。局部临床症状包括蜂窝织炎、水肿、水疱、坏死和气肿；也可能出现全身脓毒症症状。4例患者伴有慢性疾病。3例感染为多微生物感染。控制这种潜在致命的软组织感染基于早期临床诊断、及时广泛的手术清创和适当的抗生素治疗。总死亡率为7例中的1例（14%）。死亡原因是伤口持续脓毒症和全身脓毒症并发症，但主要是手术治疗延误。慢性衰弱性疾病（糖尿病、酗酒、肾功能不全等）的存在会导致局部和全身感染率增加。
