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Cervical necrotizing fasciitis: 10 years' experience at a single institution.

Abstract：

OBJECTIVE:To evaluate clinical and microbiologic characteristics, modalities of treatment and outcome of patients with cervical necrotizing fasciitis admitted to our institution. DESIGN:Retrospective clinical investigation. PATIENTS AND METHODS:We reviewed the charts of 20 consecutive patients hospitalized in our Intensive Care Unit between January 1987 and June 1998 with the diagnosis of cervical necrotizing fasciitis. RESULTS:All the patients required mechanical ventilation. Four of them had mediastinal involvement. The organisms most commonly implicated included Streptococcus, Prevotella, and Peptostreptococcus species. Patients with adequate surgery had a better outcome than those with inadequate surgical procedures. Because no evidence-based recommendations exist in the field of head and neck infections, hyperbaric oxygen was not used as adjunctive therapy. Of the 20 patients, 3 (15 %) died. CONCLUSION:The main finding of this study is that prompt, rather than delayed, surgical débridement correlates with a decrease in morbidity and mortality. However, no definite conclusion is justified due to the relatively small number of patients. Immediate radical débridement, and early redébridement if needed, appropriate antibiotics and intensive care support are critical in controlling these life-threatening infections.

journal_name

Intensive Care Med

journal_title

Intensive care medicine

authors

Mohammedi I,Ceruse P,Duperret S,Vedrinne J,Boulétreau P

doi

10.1007/s001340050959

keywords:

subject

Has Abstract

pub_date

1999-08-01 00:00:00

pages

829-34

issue

8

eissn

0342-4642

issn

1432-1238

pii

90250829.134

journal_volume

25

pub_type

杂志文章

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