Consideration of Necrotizing Fasciitis

괴사성 근막염의 고찰

  • Jung, Seok Hyun (Department of Plastic and Reconstructive Surgery, Bundang CHA Hospital, College of Medicine, Pochon CHA University) ;
  • Kim, Dong Chul (Department of Plastic and Reconstructive Surgery, Bundang CHA Hospital, College of Medicine, Pochon CHA University) ;
  • Cho, Sang Hun (Department of Plastic and Reconstructive Surgery, Dongkook University Ilsan Hospital) ;
  • Han, Byung Ki (Department of Plastic and Reconstructive Surgery, Bundang CHA Hospital, College of Medicine, Pochon CHA University) ;
  • Kang, Sang Yoon (Department of Plastic and Reconstructive Surgery, Bundang CHA Hospital, College of Medicine, Pochon CHA University)
  • 정현석 (포천중문 의과대학교 분당차병원 성형외과학교실) ;
  • 김동철 (포천중문 의과대학교 분당차병원 성형외과학교실) ;
  • 조상헌 (동국대학교 의과대학 성형외과학교실) ;
  • 한병기 (포천중문 의과대학교 분당차병원 성형외과학교실) ;
  • 강상윤 (포천중문 의과대학교 분당차병원 성형외과학교실)
  • Received : 2006.12.05
  • Published : 2007.05.10

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

References

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