Necrotising fasciitis or pyoderma gangrenosum: A fatal dilemma.
Necrotising fasciitis (NF) is mostly a polymicrobial, severe soft tissue infection that progresses rapidly, penetrating through the subcutaneous tissue to the fascial planes and the muscles. The pyoderma gangrenosum (PG), on the other hand, is a rare, rapidly progressive (except for the post‐surgica...
| Publicado en: | International Wound Journal Vol. 16; no. 6; pp. 1347 - 1354 |
|---|---|
| Autores principales: | , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Dec2019
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=139861767&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 139861767 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17424801 1725 jtl: International Wound Journal issn: 17424801 maglogo: Y pubinfo: dt: Dec2019 vid: 16 iid: 6 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 139861767 139861767 139861767 10.1111/iwj.13196 139861767 ppf: 1347 ppct: 7 formats: tig: atl: Necrotising fasciitis or pyoderma gangrenosum: A fatal dilemma. aug: au: Demirdover, Cenk Geyik, Alper Vayvada, Haluk affil: Department of Plastic, Reconstructive and Aesthetic Surgery of Dokuz Eylul University, Izmir Turkey sug: subj: Fasciitis, Necrotizing Diagnosis Pyoderma Gangrenosum Diagnosis Pyoderma Gangrenosum Surgery Fasciitis, Necrotizing Surgery Pyoderma Gangrenosum Mortality Fasciitis, Necrotizing Mortality Mortality Risk Factors Risk Assessment Disease Attributes Human Clinical Competence Retrospective Design Age Factors Sex Factors Male Female Diagnosis, Laboratory Methods Fasciitis, Necrotizing Risk Factors Fasciitis, Necrotizing Microbiology Pyoderma Gangrenosum Risk Factors Socioeconomic Factors Middle Age Aged Adult Rheumatic Diseases Diabetes Mellitus Odds Ratio Confidence Intervals Magnetic Resonance Imaging Tomography, X-Ray Computed Ultrasonography Methods Diagnosis, Differential Surgical Debridement Mortality Prevention and Control Middle Aged: 45-64 years Aged: 65+ years Adult: 19-44 years Male Female ab: Necrotising fasciitis (NF) is mostly a polymicrobial, severe soft tissue infection that progresses rapidly, penetrating through the subcutaneous tissue to the fascial planes and the muscles. The pyoderma gangrenosum (PG), on the other hand, is a rare, rapidly progressive (except for the post‐surgical PG), autoinflammatory ulcerative skin and soft tissue condition. In this study, we tried to emphasise the importance of diagnosing the NF as well as the PG. Although these two clinical presentations have some standard features, awareness of different symptoms in detail affect the outcome. Any surgical discipline can face NF or PG and, therefore, should be aware of them to decrease the mortality rate. Forty‐five patients with NF and PG who were treated between January 2008 and October 2018 were included in the study and evaluated retrospectively for age, sex, localisation, onset of symptoms and diagnosis, predisposing factors, characteristics of tissue defects, laboratory findings, Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC) scores, isolated microbiological agents, surgical intervention, and mortality rate. Demographic, laboratory, and clinical data were analysed. Among these 45 patients, 14 patients had PG, and 31 patients had NF. The mean age and SD for the NF and PG groups were 50.80 ± 17.67 and 50.78 ± 12.72, respectively. Five patients had rheumatological disorders; four patients had diabetes mellitus (DM) in the PG group. Males had higher risk than females in NF (odds ratio [OR] = 0.077, 95% confidence interval [CI] 0.017‐0.34), and females had higher risk in PG (relative risk [RR] = 5). We compared the LRINEC score of NF patients with PG patients. The mean value of this score was 4.53 for PG patients, and 6.06 for NF patients. Fifteen patients (33.3%) had a radiological evaluation. MRI, CT, and USI were used as imaging modalities. Necrotising fasciitis and PG are two distinct entities that are in general difficult to distinguish. Therefore, differential diagnosis and rapid treatment are crucial for lowering the mortality rate. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|