2018, Number 6
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Cir Cir 2018; 86 (6)
Necrotizing soft tissue infection on the abdominal wall. How to proceed?
Fresnedo-Pérez RM, Cabrera-Pereira A, Rodríguez-García R, Díaz-González D, Albaladejo-Magdalena J
Language: Spanish
References: 7
Page: 570-574
PDF size: 190.57 Kb.
ABSTRACT
Successful treatment of necrotizing soft tissue infections (NSTI) depends on early diagnosis and therapeutical aggressiveness,
based on surgical debridement, broad spectrum antibiotics and intensive support. A case of perforated diverticulitis (Hinchey 4)-secondary-
NSTI is presented in order to illustrate the particular considerations in the management of abdominal wall located
NSTI, supported on the evidence available in scientific literature. Several key points are identified, such as prompt and aggressive
surgical debridement; culture-guided antibiotherapy and its suspension based on microbiological negativization; and
the utilization of combined techniques of autoplastic repair and replacement, also supported on negative pressure therapy in
the abdominal wall restoration, which have shown a good outcome.
REFERENCES
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Faraklas I, Yang D, Eggerstedt M, Zhai Y, Liebel P, Graves G, et al. A multi-center review of care patterns and outcomes in necrotizing soft tissue infections. Surg Infect. 2016;17:773-8.
Marinis A, Voultsos M, Foteinos A, Tselioti P, Avraamidou A, Paschalidis N, et al. Necrotizing soft tissue infection of the right anterolateral abdominal wall caused by a ruptured gangrenous appendix in an elderly diabetic patient. Infez Med. 2015;23:182-6.
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Acosta S, Bjarnason T, Petersson U, Pålsson B, Wanhainen A, Svensson M, et al. Multicentre prospective study of fascial closure rate after open abdomen with vacuum and mesh-mediated fascial traction. Br J Surg. 2011;98:735-43.
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