Extensive necrotizing fasciitis of scrotum and abdominal wall: Report of two cases and a review of the literature

Abstract

The incidence rate of necrotizing fasciitis(NF) is low, but it has a high mortality rate. At present, it lacks experience in clinical treatment in municipal and county-level hospitals, insufficient awareness of disease risk, lack of experience in disease surgical intervention, and lack of a set of mature treatment norms and standards. Most patients have no time to transfer to a higher hospital for treatment. In January and April 2022, two cases of large-scale necrotizing fasciitis of the scrotum and abdominal wall were treated in the Department of Urology of Weifang people's Hospital respectively and were clinically cured after active surgical debridement combined with broad-spectrum antibiotics. Through the retrospective analysis of the diagnosis and treatment of two cases of necrotizing fasciitis, this paper analyzes and summarizes the scope of surgical debridement of NF, postoperative dressing changing skills, timing of multiple debridements, application and timing of vacuum sealing drainage(VSD), and the combined use of antibiotics. To provide experience for clinical diagnosis and treatment of necrotizing fasciitis.

Necrotizing Fasciitis Masquerading as Stroke: A Diagnostic Dilemma

“…While CT imaging from our patient’s initial visit to an outside emergency department the day before the presentation showed the cecal mass and perforation, it did not mention signs of NF, though early imaging is commonly negative [ 7 ]. Instead, the most common presenting signs are swelling, pain, and erythema [ 7 ].…”

“…While CT imaging from our patient’s initial visit to an outside emergency department the day before the presentation showed the cecal mass and perforation, it did not mention signs of NF, though early imaging is commonly negative [ 7 ]. Instead, the most common presenting signs are swelling, pain, and erythema [ 7 ]. It is unknown as to when the first signs of skin changes appeared in this patient, as it was not commented on in prior documentation and neither the patient nor his wife mentioned anything in that regard.…”

“…Broad-spectrum antibiotic therapy should be initiated early in the disease process, but definitive treatment should involve surgical debridement [ 15 ]. Delays in surgical intervention significantly increase mortality [ 7 ], and studies have shown that the time of the first debridement is directly related to patient prognosis [ 7 , 16 , 17 ]. As mentioned earlier, the onset of NF in our patient remains unclear, with the need for surgical debridement only becoming apparent several hours after his presentation to the emergency department.…”

Anterior Abdominal Wall Necrotizing Fasciitis Following Laparoscopic Sleeve Gastrectomy With Hiatal Hernia Repair: A Case Report

“…It is expected that the mortality rate associated with NF can reach anywhere between 25-46% [ 4 ]. Regardless of the ongoing advances in medicine, the mortality rate for NF has not changed in recent decades [ 6 ]. Those with diminished immunity, AIDS, a history of radiotherapy or chemotherapy for malignant tumors, and any other co-morbidities are more susceptible to NF resulting in a worse prognosis [ 1 , 11 ].…”