Potential Hazard of Wound Licking

Weil, Hans-Peter; Fischer-Brügge, Ulrich; Koch, Peter P.

doi:10.1056/nejm200204253461721

Cited by 8 publications

(13 citation statements)

References 3 publications

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“…(Canoso and Barza, 1993;Catena et al, 2004;Wilkerson et al, 1987). Necrotizing fasciitis may occur in almost any anatomic area but has only been reported infrequently in the upper extremity (Dahl et al, 2002;Greco and Curtsinger, 1993;Hubault-Marcade et al, 1991;Hung et al, 1988;Patel et al, 1996;Weil and Fischer-Bru¨gge, 2002;Wong and Tan, 2004;Yamane et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

Necrotizing Fasciitis of the First Ray Caused by Group a Streptococcus

Lesaffer¹,

Holder²,

Haeck³

2006

Journal of Hand Surgery

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Section: Discussionmentioning

confidence: 99%

Necrotizing Fasciitis of the First Ray Caused by Group a Streptococcus

Lesaffer¹,

Holder²,

Haeck³

2006

Journal of Hand Surgery

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“…Animals show multiple behaviors in response to acute and chronic pain, including active coping methods like wound licking (an instinctive behavior that cleans and disinfects wounds ( 49 )) and more passive strategies such as paw guarding to reduce allodynia; for the purpose of comparison to experimental data, this model focuses only on wound licking behavior. Excess wound licking leads to risk of lesion formation and infection ( 50 ), and the act of wound licking costs energy and saliva and comes with an “opportunity cost”, in that it prevents the animal from pursuing other activities required for survival. “Effort” in this model may therefore be taken as an abstract variable that encapsulates the overall negative consequences of licking more than is necessary to reduce pain.…”

Section: Methodsmentioning

confidence: 99%

A parabrachial hub for the prioritization of survival behavior

Goldstein,

Maes,

Allen

et al. 2024

Preprint

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Long-term sustained pain in the absence of acute physical injury is a prominent feature of chronic pain conditions. While neurons responding to noxious stimuli have been identified, understanding the signals that persist without ongoing painful stimuli remains a challenge. Using an ethological approach based on the prioritization of adaptive survival behaviors, we determined that neuropeptide Y (NPY) signaling from multiple sources converges on parabrachial neurons expressing the NPY Y1 receptor to reduce sustained pain responses. Neural activity recordings and computational modeling demonstrate that activity in Y1R parabrachial neurons is elevated following injury, predicts functional coping behavior, and is inhibited by competing survival needs. Taken together, our findings suggest that parabrachial Y1 receptor-expressing neurons are a critical hub for endogenous analgesic pathways that suppress sustained pain states.

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“…Generally, early symptoms of necrotizing fasciitis present as fever, erythema, edema, development of bullae, and pain out of proportion in the affected area. 2,[5][6][7] The most common symptoms were edema and pain, reported in 51 (94%) 5,10,[12][13][14][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][33][34][35][36][37][38][39][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66]68,69,71,72 and 44 (82%)…”

Section: Presentation/diagnosismentioning

confidence: 99%

“…2,[5][6][7] The most common symptoms were edema and pain, reported in 51 (94%) 5,10,[12][13][14][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][33][34][35][36][37][38][39][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66]68,69,71,72 and 44 (82%) 10-17,19-31, 33-35,37-39,51,53,56-61,63-65,67-69,71 cases reviewed, respectively. Erythema was present in 24 (44%) patients,…”

Section: Presentation/diagnosismentioning

confidence: 99%

Necrotizing Fasciitis of the Upper Extremity: A Systematic Review of the Literature

Bilolikar,

Rengifo,

Desai

et al. 2023

SurgiColl

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Objectives Through this review, we sought to accomplish two goals: 1) analyze and synthesize the published case reports on upper extremity necrotizing fasciitis and 2) identify any trends in the diagnosis and treatment of upper extremity necrotizing fasciitis. Methods Studies included in this systematic review were conducted per PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines with the following eligibility criteria: (1) single case or limited case series, (2) established diagnosis of necrotizing fasciitis in the hand, wrist, or forearm, (3) English language publication. Results Most of the patients in this review (38, (70.37%)) presented with an inciting injury. A minority of patients had other associated co-morbidities independent of injury, including Diabetes Mellitus, immunosuppression, and IV drug use. The most common infectious agents were gram-positive cocci, identified in 32 (59.26%) cases, followed by gram-negative bacilli in 21 (38.89%) cases. The most common pathogen was Group A streptococcus (GAS), reported in 15 (27.78%) cases, followed by Vibrio vulnificus in 6 (11.11%) cases. Most patients were managed with empiric antibiotic treatment. Fifty patients (92.6%) reported surgical intervention and 45 (83.3%) had at least one debridement. Most patients in the cases reviewed had either no or minimal long-term sequelae following their infection. Conclusion Early recognition of the signs and symptoms of necrotizing fasciitis is imperative to avoid loss of limb and/or death. Further, aggressive management with empiric antibiotic coverage and rapid surgical intervention improves outcomes in patients with necrotizing fasciitis of the upper extremity.

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Potential Hazard of Wound Licking

Cited by 8 publications

References 3 publications

Necrotizing Fasciitis of the First Ray Caused by Group a Streptococcus

Necrotizing Fasciitis of the First Ray Caused by Group a Streptococcus

A parabrachial hub for the prioritization of survival behavior

Necrotizing Fasciitis of the Upper Extremity: A Systematic Review of the Literature

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