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Necrotizing fascitis of neck

Joelle B Karlik, Vincent Duron, Leonard A Mermel, Peter Mazzaglia
BACKGROUND: Thyroidectomy is rarely complicated by a surgical site infection (SSI). Despite its low incidence, post-thyroidectomy SSI is especially concerning because of its proximity to vital head and neck structures and the very real potential for airway compromise and death. Severe SSIs frequently are caused by Group A Streptococcus (GAS) because of its potential for developing into necrotizing fascitis. No description of the surgical approach to a necrotizing soft-tissue infection after thyroid resection is available in the current literature...
April 2013: Surgical Infections
Yoshihiro Moriwaki, Mitsugi Sugiyama, Masayuki Iwashita, Nobuyuki Harunari, Hiroshi Toyoda, Takayuki Kosuge, Shinju Arata, Noriyuki Suzuki
Tracheostomy is hardly performed in patients with cervical infection close to the site of the tracheostomy. This study aimed to present and clarify the usefulness and safety of open tracheostomy performed by the paramedian approach technique. The procedure is as follows. A 2.5-cm paramedian incision is made for the tracheostomy on the opposite side of infectious focus; the anterior neck muscles are dissected and split; the trachea is fenestrated by a reverse U-shaped incision; and the fenestral flap of the trachea is fixed to the skin...
November 2010: American Surgeon
A S Adoga, A A Otene, S J Yiltok, A Adekwu, O G B Nwaorgu
INTRODUCTION: Cervical necrotizing fasciitis is a fatal and rapid multi- bacteria infection causing extensive necrosis of the subcutaneous tissues and fascial planes with resultant skin gangrene and associated systemic manifestation. The aim of the present study is to report four cases of cervical necrotizing fascitis highlighting their source. METHOD: The case notes of the patients were retrieved and reviewed, literature search was done using Medline, journals available and various texts...
April 2009: Nigerian Journal of Medicine: Journal of the National Association of Resident Doctors of Nigeria
Beata Walkowiak, Ryszard Zaba, Zbigniew Zaba, Katarzyna Mikołajczyk, Grzegorz Grzybowski, Włodzimierz Samborski
Necrotizing fascitis (NF) is a rare disease with a mortality rate ranging from 24 to 60 percent. The infection may be mono- or polymicrobial and is characterized by extensive necrosis of the skin and muscle, as well as fascia and subcutaneous tissue. NF may develop at the site of injury, e.g. trauma, needle puncture, or surgical incision. The lower extremities, perineum, and abdominal wall are common sites of NF. The remaining 10 percent of cases occur in the upper extremities or neck, usually in patients with vascular disease or diabetes mellitus...
2006: Annales Academiae Medicae Stetinensis
Brian T Andrews, Russell B Smith, David P Goldstein, Gerry F Funk
BACKGROUND: The vacuum-assisted closure system (V.A.C.), or negative pressure dressings, has been successfully used to manage complex wounds of the torso and extremities, but its role in the head and neck region has not been frequently described. METHODS: A retrospective study was performed. The V.A.C. system (Kinetic Concepts Inc., San Antonio, TX) was used at the University of Iowa Hospitals and Clinics for management of complicated head and neck wounds. RESULTS: The V...
November 2006: Head & Neck
J A Díaz Manzano, M F Cegarra Navarro, A Medina Banegas, E López Meseguer
The Ludwig angina is an infection of the base of the mouth and submandibular region, frecuently after a dental extraction or a piece in bad state. When it surpassees the milohioid muscle it extends dissecting the superficial aponeurotic planes, and can evolve to a necrotisant fascitis. We present the case of a 67 years old man with a painful tumefaction of the mouth base and submandibular region. The CT reflected an heterogenous submaxilar lesion that extended by the deep cervical fascia introducing itself in the thorax...
2006: Anales Otorrinolaringológicos Ibero-americanos
Gino Marioni, Roberto Rinaldi, Giancarlo Ottaviano, Rosario Marchese-Ragona, Marina Savastano, Alberto Staffieri
Necrotizing fasciitis is a soft-tissue infection characterized by progressive destruction of fascia and adipose tissue which may not involve the skin. Cervical necrotizing fascitis (CNF) is an uncommon clinical entity. The development of CNF is frequently related to synergistic infections of aerobic and anaerobic organisms of the upper aerodigestive tract. We describe the first case of CNF due to multi-drug resistant Burkholderia cepacia and Peptostreptococcus infection in an immuno-competent patient without cystic fibrosis...
November 2006: Journal of Infection
P G Djupesland
Necrotizing fasciitis (NF) of the head and neck is a rare but potentially life-threatening soft tissue infection primarily affecting the superficial fascial planes. It is caused by group A streptococci or by a synergistic combination of aerobe and anaerobe micro-organisms. If proper treatment is delayed, the infection may cause extensive necrosis of overlying skin, extend to deeper planes and produce severe systemic toxicity. Recent reviews suggest that cervical and facial NF should be considered separate clinical entities with different clinical features and prognosis...
2000: Acta Oto-laryngologica. Supplementum
G Sinkovits
A case of a patient, who has recovered from odontogen necrotising fascitis of the neck, is described. The pathophysiological and bacterial aspects are summarised. The following are important: definite and early surgical intervention, uncovered wound treatment, combined antibiotic therapy because of the aerobe and anaerobe bacterias and intensive care if necessary.
December 1997: Fogorvosi Szemle
J M Black
This article addresses methods of reconstruction for major acquired and traumatic soft-tissue defects in adults. The reconstructive ladder is used as a basis for discussing the various options for surgical closure. Conditions such as facial trauma, head and neck cancer, median sternotomy, sternal osteomyelitis, bronchopleural fistula, necrotizing fascitis, pressure ulcers, and degloving injuries are used as examples of reconstruction. Nursing aspects, including postoperative flap monitoring, are reviewed. Outcomes of reconstruction, including flap failure, are addressed...
June 1996: Critical Care Nursing Clinics of North America
Y P Krespi, W Lawson, S M Blaugrund, H F Biller
Necrotizing fascitis of the head and neck is a rare condition with only 7 cases recorded in the literature. Two cases are presented in which there was massive necrosis of the soft tissues of the neck with extension into the mediastinum. The offending organisms were a mixed bacterial flora which produced gangrene accompanied by subcutaneous emphysema. Both patients were successfully treated with a regimen of intravenous antibiotics, fasciotomy, radical debridement, and hyperbaric oxygenation (1 case). The clinical features, bacteriology, and treatment of necrotizing faciities are reviewed...
July 1981: Head & Neck Surgery
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