Postoperative Synergistic Gangrene After Spinal Fusion

Kauffman, Christopher P.; Bono, Christopher M.; Vessa, Paul; Swan, Kenneth G.

doi:10.1097/00007632-200007010-00020

Cited by 8 publications

(6 citation statements)

References 16 publications

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“…3,7–9 Given these patients may present to a range of non-surgical specialties, early assessment and referral is of vital importance. Outlined below is our management strategy for this case which will serve as a guide for other clinicians treating synergistic gangrene.…”

Section: Discussionmentioning

confidence: 99%

“…Synergistic gangrene is mostly seen at surgical sites such as the abdomen or back 6 , 7 but cases involving the peri-anal region and vulva with no proceeding trauma have been reported. 3 – 5 It is characterized by spreading cellulitis followed by the formation of central ulcerated areas covered with eschar and necrosis which grow relentlessly unless treated.…”

Section: Discussionmentioning

confidence: 99%

“…Despite there being considerable discrepancy in the agreed diagnostic criteria, the literature is unanimous in the requirement for prompt, aggressive antibiotic therapy and early, radical surgical intervention. 3 , 7 – 9 Given these patients may present to a range of non-surgical specialties, early assessment and referral is of vital importance. Outlined below is our management strategy for this case which will serve as a guide for other clinicians treating synergistic gangrene.…”

Section: Discussionmentioning

confidence: 99%

“… 3 – 5 Adequate steps are required to prevent these in addition to meeting nutritional needs to allow an appropriate immune response and adequate wound healing. Hyperbaric wound oxygenation has also been reported as an adjunct, but its efficacy is uncertain; 5 , 7 , 9 Broad spectrum antibiotics: The ideal choice of antibiotics is difficult to ascertain due to significant bacterial heterogeneity and low frequency of this condition. Most follow necrotizing fasciitis guidelines with reasonable effect.…”

Section: Discussionmentioning

confidence: 99%

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Synergistic gangrene of the breast in a patient with type 2 diabetes

Parker

Sabanathan

2011

JRSM Short Reports

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Synergistic gangrene of the breast in a patient with type 2 diabetes

Parker

Sabanathan

2011

JRSM Short Reports

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“…There is only one published report concerning gangrenous fascia infection after vertebral surgery 27 . Emergency surgical debridement of massive scope is required for this rare complication.…”

Section: Treatment Of Cervical Postoperative Infectionmentioning

confidence: 99%

Progress in diagnosis and treatment of cervical postoperative infection

Che¹,

Li²,

Dong³

2011

Orthopaedic Surgery

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Postoperative infection is the commonest complication that causes failure of spinal surgery. Although the rate of infection after cervical surgery is lower than that after lumbar surgery, the absolute number of cases is increasing. In recent years, new techniques, such as serum amyloid A and fludeoxyglucose ( 18 F) positron emission tomography (18F-FDG PET), have emerged and gradually been employed in the diagnosis of postoperative infection, updating the ability to identify the presence of infection. Most patients with cervical postoperative infection require re-operation. There are three principles for such surgery: thorough debridement, adequate drainage and ensuring stability of the spine. Some severe cases even need emergency surgery. This article aims to discuss the controversial issues in diagnosis and treatment of cervical postoperative infection, as well as progress in related studies.Key words: Cervical vertebrae; Diagnosis; Infection; Surgical procedures, operative; Therapy Cervical postoperative infections occur after cervical spine surgery and other invasive operations. The incidence of cervical postoperative infection is lower than that of postoperative infection of other parts of the spine. However, in recent years with the increasing amount of cervical spine surgery and the launching of new treatment, the absolute number of cases has increased, which has drawn more clinical attention to this issue.It has been reported that the infection rate after anterior cervical surgery is in the 0-1% range 1,2 , and that posterior cervical surgery operation has a relatively higher risk of infection, about 1% with simple decompression and 4.5-9% with internal fixation 3,4 . Classificationo s4_140 152..157Cervical postoperative infection is classified as superficial or deep according to the level of infection 5 . Superficial infection is limited to the skin and subcutaneous layers, and does not involve the deep fascia. Deep infection refers to the infection in the deep fascia (nuchal ligament and platysma muscle) and involves muscle and its underlying compartments. Deep infection includes intervertebral disc inflammation (also called intervertebral space infection), vertebral osteomyelitis and epidural abscess. Cervical postoperative infection can also be classified according to its time of occurrence as early (within 3 weeks of the operation) and late-onset infection (more than 4 weeks after surgery).

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Pitfalls in Cervical Spine Surgery

Denaro¹,

D’Avella²,

Denaro³

2010

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Postoperative Synergistic Gangrene After Spinal Fusion

Cited by 8 publications

References 16 publications

Synergistic gangrene of the breast in a patient with type 2 diabetes

Synergistic gangrene of the breast in a patient with type 2 diabetes

Progress in diagnosis and treatment of cervical postoperative infection

Pitfalls in Cervical Spine Surgery

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