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Necrotizing soft tissue infection

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https://www.readbyqxmd.com/read/29428033/definitive-wound-closure-techniques-in-fournier-s-gangrene
#1
Margaret Lauerman, Olga Kolesnik, Habeeba Park, Laura S Buchanan, William Chiu, Ronald B Tesoriero, Deborah Stein, Thomas Scalea, Sharon Henry
Necrotizing soft tissue infection of the perineum, or Fournier's gangrene (FG), is a morbid and mortal diagnosis. Despite the severity of FG, the optimal definitive wound closure strategy is unknown, as are long-term wound outcomes. A retrospective review was performed over a 3-year period at a single trauma center. Patients were managed according to our institutional approach focusing on primary wound closure and secondary intention healing in residual wounds. Overall 168 patients were included. Complete primary wound closure was accomplished in 39...
January 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29424798/group-b-streptococcal-cellulitis-and-necrotizing-fasciitis-in-infants-a-systematic-review
#2
Monika Wojtera, Horace Cheng, Kyle Fiorini, Kevin Coughlin, Michelle Barton, Julie Strychowsky
BACKGROUND: There is no consensus regarding approaches to infantile group B streptococcal (GBS) head and neck cellulitis and necrotizing fasciitis. We present a case of GBS necrotizing cellulitis and summarizes the literature regarding the presentation and management of infantile head and neck GBS cellulitis and necrotizing fasciitis. METHODS: The literature was searched using PubMed, Web of Science, EMBASE, and Medline (inception to April 2017) by two independent review authors...
February 7, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29417246/necrotizing-soft-tissue-infections-at-a-tertiary-referral-hospital-in-rwanda-epidemiology-and-risk-factors-for-mortality
#3
Christophe Mpirimbanyi, Jennifer Rickard, Charles Furaha, Faustin Ntirenganya
BACKGROUND: Necrotizing soft tissue infections (NSTI) are emergency surgical conditions with severe physiologic and metabolic derangement. These infections are associated with increased rates of mortality and morbidity worldwide, particularly in developing countries if not diagnosed and treated early. METHODS: This prospective, observational cohort study includes all patients aged 12 and above who presented at Department of Surgery, University Teaching Hospital of Kigali from April 2016 to January 2017 with NSTI...
February 7, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29404597/cellulitis-and-soft-tissue-infections
#4
Rachel Bystritsky, Henry Chambers
Cellulitis and soft tissue infections are a diverse group of diseases that range from uncomplicated cellulitis to necrotizing fasciitis. Management of predisposing conditions is the primary means of prevention. Cellulitis is a clinical diagnosis and thus is made on the basis of history and physical examination. Imaging may be helpful for characterizing purulent soft tissue infections and associated osteomyelitis. Treatment varies according to the type of infection. The foundations of treatment are drainage of purulence and antibiotics, the latter targeted at the infection's most likely cause...
February 6, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29391107/mandatory-operative-re-exploration-after-initial-debridement-of-necrotizing-soft-tissue-infections-is-it-mandatory
#5
Lara H Spence, Huan Yan, Ashkan Moazzez, Alexander Schwed, Jessica Keeley, Mohammad Karimzada, Mari Allison, Angela Neville, David Plurad, Brant Putnam, Christian de Virgilio, Dennis Kim
Necrotizing soft tissue infections (NSTIs) are aggressive infections requiring prompt diagnosis and extensive surgical debridement. Traditionally, patients undergo mandatory re-exploration to ensure adequacy of source control. The purpose of this study is to determine if re-exploration in the operating room is mandatory for all patients with NSTIs. An eight-year retrospective analysis of adult patients with NSTIs was performed comparing two groups: mandatory operative re-exploration versus operative re-exploration based on clinical examination findings...
October 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29387911/necrotizing-soft-tissue-infection-following-femoral-venous-catheter-infection
#6
Laura Atger, Anna Deho, Nicolas Apostolou, Michael Levy
No abstract text is available yet for this article.
January 31, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29322228/-necrotizing-fasciitis-of-the-hand-and-forearm-acute-surgical-treatment-and-defect-reconstruction-with-matriderm%C3%A2-and-split-thickness-skin-graft
#7
B Niedermueller, G Singer, P Pickl, M Jesacher
This case report describes a 55-year-old male patient with type II necrotizing fasciitis (NF) of the hand and forearm. The rapid progression of the tissue infection could be successfully stopped with radical surgical débridement and antibiotic therapy. For the reconstruction of the extensive loss of soft tissue a combination of split-thickness skin graft (STSG) and the synthetic dermal substitute MatriDerm® was used. In cases of NF, MatriDerm® and STSG provide a rapidly available and simple alternative to other reconstruction techniques...
January 10, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29321421/a-fatal-case-of-super-super-obesity-bmi-80-in-a-patient-with-a-necrotic-soft-tissue-infection
#8
Toshihiko Yoshizawa, Kouhei Ishikawa, Hiroki Nagasawa, Ikuto Takeuchi, Kei Jitsuiki, Kazuhiko Omori, Hiromichi Ohsaka, Youichi Yanagawa
A 35-year-old man (height, 169 cm; body weight,240 kg; BMI, 84) visited the Department of Dermatology due to left leg pain and swelling. Focused enhanced computed tomography (CT) of the left leg ruled out complications of deep venous thrombosis. Surgical exploration of the left leg resulted in a diagnosis of necrotic soft tissue infection, but amputation was ruled out due to his weight. The patient ultimately died of multiple organ failure on the fourth day of hospitalization. A culture of the surgical material revealed Streptococcus dysgalactiae...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29313940/big-data-in-small-diseases-the-case-of-necrotizing-soft-tissue-infections
#9
EDITORIAL
I Garcia-Doval, T Nijsten
No abstract text is available yet for this article.
December 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/29299899/clinical-guidelines-for-the-antibiotic-treatment-for-community-acquired-skin-and-soft-tissue-infection
#10
Yee Gyung Kwak, Seong Ho Choi, Tark Kim, Seong Yeon Park, Soo Hong Seo, Min Bom Kim, Sang Ho Choi
Skin and soft tissue infection (SSTI) is common and important infectious disease. This work represents an update to 2012 Korean guideline for SSTI. The present guideline was developed by the adaptation method. This clinical guideline provides recommendations for the diagnosis and management of SSTI, including impetigo/ecthyma, purulent skin and soft tissue infection, erysipelas and cellulitis, necrotizing fasciitis, pyomyositis, clostridial myonecrosis, and human/animal bite. This guideline targets community-acquired skin and soft tissue infection occurring among adult patients aged 16 years and older...
December 2017: Infection & Chemotherapy
https://www.readbyqxmd.com/read/29281989/necrotizing-soft-tissue-infection-clinical-characteristics-and-outcomes-at-a-reconstructive-center-in-jilin-province
#11
Jing-Chun Zhao, Bo-Ru Zhang, Kai Shi, Xi Zhang, Chun-Hui Xie, Jian Wang, Qing-Hua Yu, Xin-Xin Gao, Lei Hong, Jia-Ao Yu
BACKGROUND: To investigate the clinical characteristics and treatment outcomes in necrotizing fasciitis (NF) patients in a reconstructive unit in northeastern China. METHODS: Medical records of patients diagnosed with and treated for NF in the extremities from November 2013 to December 2016 were retrospectively reviewed. Demographic data, clinical presentation, duration of signs and symptoms, location of infection, predisposing factors, causative microbiological organisms, laboratory risk indicator for necrotizing fasciitis (LRINEC) score, number of surgical debridements, length of hospital stay, treatments, and outcomes were recorded...
December 28, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29281190/hyperbaric-oxygen-therapy-as-an-adjuvant-to-source-control-in-necrotizing-soft-tissue-infections
#12
António Pedro Pinto Ferreira, Sérgio Santos Vide, Tiago David Fonseca Fernandes, Pedro Miguel Barata de Silva Coelho, Óscar Ferraz Camacho
INTRODUCTION: Necrotizing soft tissue infections (NSTI) are rare but potentially lethal disorders, and adequate management is time- and resource-demanding. This study aims to assess whether variations in the treatment modalities - surgery, hyperbaric oxygen (HBO₂) therapy and negative pressure wound therapy - had an impact on the length to definitive source control in NSTI patients who underwent HBO₂. METHODS: This is a retrospective study of all NSTI patients treated with hyperbaric oxygen therapy between March 2007 and May 2015 at Unidade Local de Saúde de Matosinhos (ULSM) Hyperbaric Unit...
November 2017: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
https://www.readbyqxmd.com/read/29278528/treatment-of-severe-skin-and-soft-tissue-infections-a-review
#13
Jason P Burnham, Marin H Kollef
PURPOSE OF REVIEW: To review the salient features of the management of severe skin and soft tissue infections (SSTIs), including toxic shock syndrome, myonecrosis/gas gangrene, and necrotizing fasciitis. RECENT FINDINGS: For severe SSTIs, intensive care, source control, and broad-spectrum antimicrobials are required for the initial phase of illness. There is an increasing focus on the utility of rapid diagnostic tests to help in selection and de-escalation of antimicrobials for SSTIs...
December 22, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/29250312/severe-fournier-s-gangrene-a-conjoint-challenge-of-gynaecology-and-plastic-surgery
#14
M Wähmann, M Wähmann, F Schütz, C Sohn, S Schott, T Kremer, J F Hernekamp, U Kneser
Necrotizing fasciitis (NF) is a rare soft tissue infection characterized by rapidly progressing necroses and a high mortality. Prompt diagnosis and immediate medical treatment including radical debridement and broad spectrum antibiotics are the key to successful management. We report on a 46-year-old diabetic female who developed extensive, deep necroses in the perineal area and proximal thighs within a few days. After initial gynaecological consultation, she was transferred directly to our department. Due to the suspicion of NF, an immediate radical debridement was performed...
December 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29250041/stenotrophomonas-maltophilia-as-an-emerging-ubiquitous-pathogen-looking-beyond-contemporary-antibiotic-therapy
#15
REVIEW
Anthony A Adegoke, Thor A Stenström, Anthony I Okoh
Stenotrophomonas maltophilia is a commensal and an emerging pathogen earlier noted in broad-spectrum life threatening infections among the vulnerable, but more recently as a pathogen in immunocompetent individuals. The bacteria are consistently being implicated in necrotizing otitis, cutaneous infections including soft tissue infection and keratitis, endocarditis, meningitis, acute respiratory tract infection (RTI), bacteraemia (with/without hematological malignancies), tropical pyomyositis, cystic fibrosis, septic arthritis, among others...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29243739/frozen-sections-are-unreliable-for-the-diagnosis-of-necrotizing-soft-tissue-infections
#16
Isaac H Solomon, Rene Borscheid, Alvaro C Laga, Reza Askari, Scott R Granter
Necrotizing soft tissue infections are rare but are associated with high rates of morbidity and mortality. The use of bedside or intraoperative frozen sections has been reported to be associated with faster diagnosis and better outcomes; however, to date no large studies have been published to determine the sensitivity and specificity of frozen sections in this setting. Twenty years of cases suspicious for necrotizing soft tissue infection at a large academic referral center were reviewed, blinded to the final clinical diagnosis (gold standard)...
December 15, 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/29231774/modern-management-of-diabetic-foot-osteomyelitis-the-when-how-and-why-of-conservative-approaches
#17
Javier Aragón-Sánchez, Benjamin A Lipsky
Diabetic foot osteomyelitis (DFO) has long been considered a complex infection that is both difficult to diagnose and treat, and is associated with a high rate of relapse and limb loss. Areas covered: DFO can usually be diagnosed by a combination of clinical evaluation, serum inflammatory markers and plain X-ray. When the results of these procedures are negative or contradictory, advanced imaging tests or bone biopsy may be necessary. Staphylococcus aureus remains the most frequent microorganism isolated from bone specimens, but infection is often polymicrobial...
January 2018: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/29211672/necrotizing-soft-tissue-infections
#18
REVIEW
Dennis L Stevens, Amy E Bryant
New England Journal of Medicine, Volume 377, Issue 23, Page 2253-2265, December 2017.
December 7, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29211657/open-to-air-is-a-viable-option-for-initial-wound-care-in-necrotizing-soft-tissue-infection-that-allows-early-detection-of-recurrence-without-need-for-painful-dressing-changes-or-return-to-operating-room
#19
Derek Yang, April Davies, Bailey Burge, Phillip Watkins, Sharmila Dissanaike
BACKGROUND: The standard treatment of necrotizing soft tissue infection (NSTI) includes extensive surgical debridement. Care of these debridements is challenging because of the size of the wound and associated pain. A potential solution is to leave the wounds open-to-air in the period after the initial debridement, allowing for regular inspection at bedside while reducing pain associated with frequent dressing changes. We evaluated the feasibility of this approach from a pain control standpoint...
December 6, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29208199/-amputation-of-an-arm-due-to-infection-with-vibrio-vulnificus-after-beach-holiday
#20
Esra Arici, Allan Evald, Dennis Back Holmgaard, Lars Quist, Susanne Dam Poulsen, Signe W Worm
Infection with Vibrio vulnificus is a rare condition with approximately 11 cases reported in the Danish literature. It is characterized by soft tissue infection/wound, necrotizing fasciitis and septicaemia. In this case report we present a patient admitted with a rapid progression and sepsis consistent with V. vulnificus infection but with no informa-tion of water exposure. The initial treatment was surgery and sepsis management including broad-spectrum antibiotics. On day eight the patient's right arm was amputated...
November 27, 2017: Ugeskrift for Laeger
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