Consideration of Necrotizing Fasciitis.

Jung, Seok Hyun; Kim, Dong Chul; Cho, Sang Hun; Han, Byung Ki; Kang, Sang Yoon

Search: J Korean Soc Plast Reconstr Surg Search

CLOSE

Case Report

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2007;34(3):383-387.
Published online May 1, 2007.

Consideration of Necrotizing Fasciitis.

Seok Hyun Jung, Dong Chul Kim, Sang Hun Cho, Byung Ki Han, Sang Yoon Kang

¹Department of Plastic and Reconstructive Surgery, Bundang CHA Hospital, College of Medicine, Pochon CHA University, Korea. sykang@cha.ac.kr
²Department of Plastic and Reconstructive Surgery, Dongkook University Ilsan Hospital, Gyonggi, Korea.

Abstract

PURPOSE
A necrotizing fasciitis is a rare, but insidiously advancing fatal soft tissue infection characterized by extensive fascial necrosis. Diagnosis & treatment of this disease are difficult. Necrotizing fasciitis tend to begin with constitutional symptoms of fever and chills. Quite a many lab studies and imaging studies such as standard radiography, computerized tomography can be used, but nothing can confine the extent of affected tissue. Aggressive surgical interventions are often required because of large skin and soft tissue deformity. However, many patients with necrotizing fasciitis are not healthy enough to overcome aggressive surgical intervention. METHODS: Since 2000, we treated 10 patients with necrotizing fasciitis. In 4 patients, we used magnetic resonance imaging(MRI) as a tool for diagnosis as soon as necrotizing fascitiis was doubted. We treated patients with delayed coverage with Alloderm(R) & split thickness skin graft or delayed wound closure in as many cases as possible.
RESULTS
In 4 patients using preoperative MRI, diagnosis could be made in earlier stage of the disease compared to other patients. Our treatment modality was debridement and coverage with Alloderm(R) & split thickness skin graft. We could reconstruct deformities without significant limitation of movement in 7 cases.
CONCLUSION
We diagnosed and treated 10 necrotizing fasciitis with MRI and Alloderm(R) graft, and results were good.

Keywords: Necrotizing fasciitis; Magnetic resonance imaging; Alloderm(R) graft

TOOLS