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Necrotizing fasciitis

Fascitis necrosante




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Review Articles

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Mendoza Ramírez, O. E., & Medina Lombo, R. A. (2007). Necrotizing fasciitis. Journal of Medicine and Surgery Repertoire, 16(1), 7-16. https://doi.org/10.31260/RepertMedCir.v16.n1.2007.451

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Oscar Eduardo Mendoza Ramírez
    Ronald Antonio Medina Lombo

      Despite being a pathology with such low incidence, necrotizing fasciitis (FN) is important for its severe sequelae and high mortality rate. This review seeks to expand the basic knowledge of a disease whose physiopathology is just beginning to be elucidated. There is a false belief that its devastating behavior is secondary to the aggressiveness of the germs involved in its etiology, however its implacable evolution is due in essence to the decrease in the perfusion of the compromised tissues, as an effect of the inflammatory cascade located in the fascias that are a space from the anatomical point of view susceptible to changes in tissue pressure. Our review seeks to clarify misconceptions through a detailed exposition of the epidemiology, pathophysiology, clinical, diagnosis and treatment, providing valuable elements so that all medical personnel, both undergraduate, as well as general health professionals and specialists, acquire the ability to identify it. and manage it early, thus achieving an important impact on their mortality. Abbreviations: FN, Necrotizing fasciitis.


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      1. Jones J. Investigation on the nature, causes and treatment of hospital gangrene as it prevails in the confederate armies 1861-1865. En: Hasting Hamilton F, editor. Surgical memoirs of the war rebellion. New York: Sanitary commission; 1871.

      2. Descamps V, Aitken J, Lee MG. Hippocrates on necrotising fasciitis. Lancet. 1994; 344 (8921): 556.

      3. Loudon I. Necrotising fasciitis, hospital gangrene, and phagedena. Lancet. 1994; 344: 1416-19.

      4. Meleney FL. Hemolytic streptococcus gangrene. Arch Surg. 1924; 9: 317-364.

      5. Meleney FL. A differential diagnosis between certain typers of infectious gangrene of the skin. Surg Gynecol Obstet. 1933; 56: 847-67.

      6. Wilson B. Necrotizing fasciitis. Am Surg. 1952; 18(4) : 416-31.

      7. Nowak R. Flesh-eating bacteria: not new, but still wirrisome. Science. 1994; 264: 1665.

      8. Trem JT, Kirshner RS. Diagnosis necrotizing fasciitis. Adv Skin Wound Care. 2002; 15: 135-38.

      9. Yuag-Meng L, Chih-Yu C, et al. Microbiology and factors affecting mortality in necrotizing fasciitis. J Microbiol Immunol Infect. 2005; 38: 430- 35.

      10. Wall DB, De Virgilio C, et al. Objective criteria may assist in distinguishing necrotizing fasciitis soft tissue infection. Am J Surg. 2000; 179 (1): 17-21.

      11. Schroeder JL, Steinke EE. Necrotizing fasciitis - the imporance of early diagnosis and debridement. AORN J. 2005; 82(6): 1031-40.

      12. Canoso J, Barza M. Soft tissue infections. Rheum Dis Clin North Am. 1993; 19: 293- 309.

      13. Voros D, Pissiotis C, et al. Role of early and extensive surgery in the treatment of severe necrotizing soft tissue infections. Br J Surg. 1993; 80: 1190-91.

      14. Chelsom J, Halstensen A, et al. Necrotising fasciitis due to group A streptococci in western Norway: mcidence and features. Lancet. 344 (8930):1111-5.

      15. Umbert IJ, Winkelmann RK, et al. Necrotizing fasciitis: a clinical, microbiologic, and histopathologic study of 14 patients. J Am Acad Dermatol. 1989; 20(5 Pt 1):774-81.

      16. Ward RG, Walsh MS. Necrotizing fascitis: 10 years' experience in district general hospital. J Am Acad Dermatol. 1991; 78: 488-89.

      17. Stephens BJ, Lathrop JC, et al. Fournier's gangrene: historic (1764-1978) versus contemporany (1979-1988) differences in etiology and clinical importance. Am Surg. 1993 ; 59 : 149-54.

      18. Fournier JA. Gangrene foudroyante de la verge. Sem Med. 1883; 3: 345-47.

      19. Kronish JW, McLeish WM. Eyelid necrosis and periorbital necrotizian fasciitis. Report of a case and review of the literature. Ophthalmology. 1991; 98(1):92-8.

      20. Sudarsky LA, Laschinger JC, et al. Improved results from a standardized approach in treating patients with necrotizing fascitis. Ann Surg. 1987; 206: 661-65.

      21. McHenry CR, Piotrowski JJ, et al. Determinants of mortality in necrotizing soft tissue infections. Ann Surg. 1995; 221: 558-63.

      22. Francis KR, Lamaute HR, et al. Implication of risk factors in necrotizing fasciitis. Am Surg. 1993; 559: 304-08.

      23. Andze G, Pagbe JJ, et al. Postoperative necrotizing fasciitis in infants. Apropos of a case. J Chir (Paris). 1995 Feb; 132(2):90-3.

      24. Angelici AM, Nasti AG, et al. Necrotizing fasciitis: our experience. G Chir. 2004; 25(5):167-70.

      25. Schwarz G, Sagy M, Barzilay Z. Multifocal necrotizing fasciitis in varicella. Pediatr Emerg Care. 1989; 5: 31-3.

      26. McHenry CR, Brandt CP, et al. Idiopathic necrotizing fascitis: recognition, incidence, and outcome of therapy. Am Surg. 1994; 60: 490-94.

      27. Laucks SS. Fournier's gangrene. Surg Clin North Am.1994; 74: 1339-52.

      28. Efem SE. The features and etiology ofFournier's gangrene. Postgrad Med. 1994; 70: 568-71.

      29. Rimailho A, Riou B, et al. Fulminant necrotizing fasciitis and nonsteroidal anti-inflammatory drugs. J Infect Dis. 1987; 55: 143-46.

      30. Brun-Buisson CJL, Saada M, et al. Haemolytic streptococcal gangrene and nonsteroidal anti-inflammatory drugs. BMJ. 1985; 290: 1786.

      31. Van Arnmers P, Moore P, Sacho H. Necrotizing fasciitisafter caesarean section - association with nonsteroidal antiinflammatory drugs. S Afr Med J. 1991; 80: 203-04.

      32. Maynor M. "Necrotizing fascitis". E-medicine [serie en Internet]. [citado 15 Ene. 2005]: [aprox 3 p.]. Disponible en: http://www.emedicine.co emerg/topic332.htm.

      33. Wong CH, Chang HC et al. Necrotizing fasciitis: clinical presentation, microbiology, and determmants of mortality. J Bone Joint Surg Am. 2003; 85-A (8): 1454-60.

      34. Majeski JA, Majeski E. Necrotizing fasciitis: improved survival with early recognition by tissue biopsy and aggressive surgical treatment. South Med J. 1997; 90: 1065-68.

      35. Majeski JA, Alexander JW. Early diagnosis, nutricional support and immediate extensive debridement improve survival in necrotizing fasciitis. Am J Surg. 1983; 145: 781-87.

      36. Bilton BD, Zibari GB, et al. Aggressive surgical management of necrotizing fasciitis serves to decrease mortality a retrospective study. Am Surg. 1998; 64: 397-401.

      37. Walshaw C, Deans 11. CT findings in necrotizing fasciitis: a report of four cases. Clin Radiol. 1996; 51: 429-32.

      38. Faucher LD, Monis SE, et al. Burn center management of necrotizing soft-tissue surgical infections in unburned patients. Am J Surg. 2001; 182(6): 563-69.

      39. Elliott DC, Kufera, JA, et al. Necrotizing soft tissue infections: risk factors for mortality and strategies for management. Ann Surg. 1996; 224(5): 672- 83.

      40. Conly J. Soft tissue infections. En: Hall JB, Schmidt GA, et al. Principles of critical care. New Cork: Mc Graw-Hill; 1992. p. 1325-34.

      41. Moore, K. Anatomía con orientación clínica. 3a ed. Madrid: Médica Panamericana; 1993.

      42. Ramsi C, Vinay K, et al. Patología estructural y funcional. 6a ed. Filadelfia: McGraw-Hill; 2000.

      43. Wong C, Wang Y. The diagnosis of necrotizing fasciitis. Curr Opin Infect Dis. 2005; 18: 101-06.

      44. Wilkerson R, Paul W, et al. Necrotizing fasciitis: review of literature ans case report. Clin Orthop Relat. 1987; 216: 187-92.

      45. Barker F, Leppard B, Seal D. Streptococcal necrotizing fasciitis: comparison between histological and clinical features. J Clin Pathol. 1987; 40: 335-41.

      46. Seal D. Necrotizing fasciitis. Curr Opin Infect Dis. 2001; 14: 127-32.

      47. Guiliano A, Lewis F, et al. Bacteriology of necrotizing fasciitis. Am J Surg. 1977; 134: 52-7.

      48. Green R, Dafoe D, et al. Necrotizing fasciitis. Chest. 1996; 110: 219-27.

      49. Fuggit J, Puckett M, et al. Necrotizing fasciitis. Radiographics. 2004; 24(5): 1472-76.

      50. Barie P. The laboratory risk indicator for necrotizing fasciitis (LRINEC) score: useful tool or paralysis by analisis?. Crit Care Med. 2004; 32(7): 1618-19.

      51. Wong C, Khin L, et al. The LRINEC (The Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections. Cnt Care Med. 2004; 32(7): 1535-41.

      52. Wong C. Clinical relevance of the LRINEC (The Laboratory Risk Indicator for Necrotizing Fasciitis) score for assessment of early Necrotizing Fasciitis. Crit Care Med. 2005; 33(7):1677.

      53. Wall, D, Klein, S, et al. A simple model to help distinguish necrotizing fasciitis from nonnecrotizing soft tissue infection. J Am Coll Surg. 2000; 191(3): 227-31.

      54. Struk D, Punk P, et al. Imaging of soft tissue infections. Radiol Clin North Am. 2001; 39: 277-301.

      55. Becker M, Zbaren P, et al. Necrotizing fasciitis of the head and neck: role of CT in diagnosis and management. Radiology. 1997; 202: 471-76.

      56. Millar T, Randolph D, et al. Fat-suppressed MRI of musculoskeletal infection: fast T2-weighted images techniques versus gadolinium-enhanced Tl-weighted images. Skeletal Radiol. 1997; 26: 654-58.

      57. Brothers T, Tagle D, et al. Magnetic resonance imaging differentiates between necrotizing fasciitis and non-necrotizing fasciitis of the lower extremity. J Am Coll Surg. 1998; 187(4): 416-21.

      58. Stamenkovic I, Lew D. Early recognition of potentially fatal necrotizing fasciitis. N Engl J Med. 1984; 310(26): 1689-93.

      59. Wang T, Hung C. Role of tissue oxygen saturation monitoring in diagnosing necrotizing fasciitis of the lower limbs. Ann Emerg Med. 2004; 44(3): 222-28.

      60. Rodríguez R, Abdullah R, et al. A pilot study of citokine levels and white blood cell counts in the diagnosis of necrotizing fasciitis. Am J Emerg Med. 2006; 24: 58-61.

      61. Muldrew K, Simpson J, et al. Molecular diagnosis of necrotizing fasciitis by 16S rRNA gene sequencing and superantigen gene detection. J Mol Diagn. 2005; 7(5): 641-45.

      62. Majeski J, John J. Necrotizing soft tissue infections: a guide to early diagnosis and imtial therapy. South Med J. 2003; 96(9):900-05.

      63. Praba-Egge A, Lanning D, et al. Necrotizing fasciitis of the chest and abdominal wall arising from an empyema, J Trauma. 2004; 56:1356-61.

      64 Patiño JF. Infecciones necrotizantes de la piel y de los tejidos blandos: guías para el manejo de urgencias. Bogotá: Ministerio de Protección Social; 2002.

      65. Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001; 345(19): 1368-77.

      66. Wu W, Lieber M. Hyperbaric oxygen therapy: ten common questions related to the management of severe necrotizing skin and soft-tissue infections. Infect Dis Clin Pract. 2001; 10:429-34.

      67.Wilkinson D; Doolette, et al. Hyperbaric medicine unit, department of anaesthesia and intensive care. Arch Surg. 2004; 139(12):1339-45.

      68. Riseman J, Zamboni W, et al. Hyperbaric oxygen therapy for necrotizing fasciitis reduces mortality and the need for debridements. Surgery. 1990; 108(5): 847-50.

      69. Harrison T, Fauci A. Principios de medicina interna. 16a ed. [Madrid]: Interamericana; 2006.

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