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Global Journal of Surgery. Volume 2, Issue 2 (2011) pp. 90-94
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Research Article
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Necrotizing fasciitis: Treatment in a burn center
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Breederveld RSa,*, Teygeler Mb, Vloemans AFPMa, Vehmeyer-Heeman MLAWc,
Tempelman FRHa, Van Zuijlen PPMd
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a Dept. of surgery, burncenter, Red Cross Hospital ,Beverwijk, The Netherlands
b Dept. of surgery, Medical Center Alkmaar, Alkmaar ,The Netherlands
c Dept. of surgery , Red Cross Hospital , Beverwijk, The Netherlands
d Dept. of plastic reconstrctive surgery, Red Cross Hospital, Beverwijk, The Netherlands
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Abstract |
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Introduction: Necrotizing fasciitis is a disastrous soft tissue infection with a very high morbidity and
mortality. Early diagnosis is often difficult and can be delayed if there is not also a high index of suspicion.
Radical serial surgical debridement with the support of antibiotic therapy and optimal critical care are the main
conditions for a positive outcome. After primary therapy, large skin defects and extensive and deep wounds are
the result of the primary therapy with the need for further treatment to close these defects. Experimental: 21
patients were admitted to the burn centre of the red cross hospital after primary treatment for necrotizing fasciitis
in other hospitals. Survival, surgical technique and length of stay were retrospectively studied. 64 procedures for
skin closure were performed in these patients. Results: 20 patients survived with a mean length of stay of 38 days,
30 further debridements and 63 skin closing procedures were performed (mean 5 per patient) for a complete
closure of the defects. Meek-Wall micrografting was the dominant skin grafting procedure used in these patients.
Conclusions: Secondary treatment for wound care and definitive treatment for wound closure of patients with
necrotizing fasciitis should be in a burn center, because of the need for many and dedicated skin closure
techniques.
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Keywords |
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Necrotizing fasciitis; Burn center; Skin graft; Meek-Wall micrograft
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