Necrotizing Fasciitis of the Lower Limb after Venous Surgery: Cases Studies and a Review of the Literature

Abstract

We report 2 cases of necrotizing fasciitis following stripping of the long saphenous vein and phlebectomy of varicose collateral vessels. The first one concerns a 42-year-old man who presented with a left thigh postoperative infection, evolving despite oral antibiotic therapy. Urgent surgical exploration proved an extensive necrosis consistent with necrotizing fasciitis. Wide excision of the necrotic tissue was performed. Under intravenous antibiotic therapy, local wound care and hyperbaric oxygen therapy, the patient's condition improved. The second case concerns a 60-year-old man with cardio-vascular disease and diabetes. He was transferred in our institution 7 days after surgery for an infection in the right thigh and septic shock. Immediate surgical exploration showed extensive necrotizing fasciitis of the thigh, popliteal fossa and latero-posterior compartments of the leg. Muscle necrosis of the right leg was also observed. A right supra-condylar amputation was performed. The patient improved under antibiotherapy and hyperbaric oxygen therapy.

Utilización de terapia de presión negativa VAC ® en el tratamiento la fascitis necrotizante cervical. Revisión sistemática

“…Afecta a personas con comorbilidades, tales como diabetes, obesidad, alcoholismo, drogadicción, enfermedad inmunológica, cirrosis, corticoterapia prolongada y enfermedad vascular periférica Ediciones Universidad de Salamanca / [ 5 ] Rev. ORL, 2024, 15, e31996, 1-10 [Publicación continua] [9,10,18]. Entre ellas, la diabetes mellitus es la patología predisponente más común (18-72%) entre los pacientes que sufren una fascitis necrotizante cervical [13], encontrándose en nuestra revisión en un 38%.…”

“…Entre ellas, la diabetes mellitus es la patología predisponente más común (18-72%) entre los pacientes que sufren una fascitis necrotizante cervical [13], encontrándose en nuestra revisión en un 38%. En ningún artículo de los revisados se recoge el consumo de alcohol y tabaco, a pesar de que se destacan como factores de riesgo para padecer la enfermedad [10,13,[18][19][20]. En otras series no se describen antecedentes de neoplasias como posible etiología de esta enfermedad, sin embargo, en nuestra revisión aparece en 4 de nuestros 18 pacientes.…”

Necrotizing Soft Tissue Infections in the Vasculopathic Patient: Review of Literature

“…13,14 NSTIs of the abdomen and perineum occur less frequently. 1 The condition is often preceded by trauma, with scald burns, 15 stab wounds, 16 or iatrogenic surgical sites 17,18 all being reported in the literature. The degree of trauma may be trivial in nature, 19,20 or significant with subsequent massive microbial contamination.…”