Successful treatment of perineal necrotising fasciitis and associated pubic bone osteomyelitis with the vacuum assisted closure system

Kumar, Susim; O’Donnell, Mark E.; Khan, Khalid; Dunne, Gillian; Carey, P. D.; Lee, John

doi:10.1186/1477-7819-6-67

Cited by 23 publications

(22 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Stage II (LRINEC scoring 6-8) may be observed for not more than 24 hours with conservative line of management and must be switched over to operative management. Stage III (LRINEC scoring ≥ 8) cases straight away need early aggressive operative line of management ranging from simple fasciotomy to aggressive repeated wound debridement, vacuum assisted closed drainage and appropriate amputations followed by delayed wound closure or reconstructive and rehabilitative procedures [36][37][38]. Results of our study as compared with those of previous similar studies are shown in TABLE 11.…”

Section: Discussionsupporting

confidence: 74%

Early diagnosis and management of Necrotizing Fasciitis

Kannan¹,

Kannan²,

Rohan³

et al. 2016

IOSR

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 74%

Early diagnosis and management of Necrotizing Fasciitis

Kannan¹,

Kannan²,

Rohan³

et al. 2016

IOSR

View full text Add to dashboard Cite

“…In addition, there may be a local inflammatory response that persists beyond debridement compromising vasculature of neighbouring tissue. Use of vacuum assisted closure combined with frequent change of dressing and debridement of non-viable tissue with delayed wound closure is the mainstay of treatment for the majority of cases of necrotising fasciitis [15][16][17]. In our small series of delayed secondary reconstruction, neither patient had a wound bed that supported a graft despite repeated debridements.…”

Section: Discussionmentioning

confidence: 99%

Outcomes following necrotising fasciitis: an 8-year review

Watson¹,

Hassan²,

Davies³

2014

Res J Infect Dis

View full text Add to dashboard Cite

Background: Necrotising soft tissue infections (NSTI) are uncommon and remain a devastating disease. This study aims to document mortality rates, assess the value of the laboratory risk indicator for necrotising fasciitis (LRINEC) score as a diagnostic tool and examine outcomes following reconstructive surgery for wound closure. Methods: A retrospective case note review of patients presenting to our institute between 2004 and 2012 with a histological or clinical diagnosis of necrotising fasciitis were identified. Results: Thirty-three patients with primary NSTI were identified with a male to female ratio of 1.6:1 and an average age of 50 years. Two patients with secondary reconstruction were identified with a male to female ratio of 1:1 and an average age of 63 years. Twenty patients required admission to the intensive care unit. On average each patient required two tissue debridements under anaesthesia to achieve a healthy wound base suitable for reconstruction. Reconstruction with an anterolateral fasciocutaneous thigh flap (ALT) was carried out in two patients (6%), delayed split skin grafting in thirteen patients (39%) and limb amputation in three patients (9%). Partial flap loss with skin necrosis requiring debridement and advancement occurred in both patients who underwent ALT, whilst complete loss of skin graft occurred in one patient. Thirty-day mortality was 27% with an average time from presentation to death approximately 5 days. Conclusion: Our experience of managing necrotising soft tissue infections has been mixed. Early diagnosis and aggressive debridement with frequent monitoring and return to theatre are essential. These interventions must be coupled with early administration of antimicrobials and supportive fluid resuscitation to provide optimal treatment in the care of NSTI patients.

show abstract

“…The principle underlying the mechanism of VSD promoting nerve repair can be associated with the following points: (1) VSD increases blood capillary bed opening and capillaries growth [2], thus improving local oxygen supply and promotion of nerve vascularization [10]. Improved microcirculation is known to promote nerve repair [11]; (2) VSD can promote the secretion of active substance of peripheral nerve, such as substance P, VEGF, platelet-derived growth factor (PDGF), transforming growth factor (TGF-β) [3,[12][13][14].…”

Section: International Journal Of Neurosciencementioning

confidence: 99%

“…This technology is significantly different from conventional suction drainage method, such as: VSD use adjustable vacuum, the working time, and pressure can be adjusted according to actual requirements; the numerous microporous vacuseal makes the negative pressure distributed uniformly on the whole wound, therefore VSD could generate full wound drainage; the semipermeable membrane and the hydrophilic vacuseal can maintain wound moist environment and the vacuseal with 400-600 μm micropore is beneficial for tissue repair [1]. Thus, VSD could promote wound vascularization [2] and vascular endothelial growth factor (VEGF) generation [3] and relieve edema around wound significantly [4]. Since VSD may contribute to peripheral nerve regeneration, we in this study propose an experiment to investigate the impact of VSD in nerve repair.…”

Section: Introductionmentioning

confidence: 98%