Features and Treatment of Gas-forming Synergistic Necrotizing Cellulitis: a Nine Year Retrospective Study [Ulus Travma Acil Cerrahi Derg]
Ulus Travma Acil Cerrahi Derg. Ahead of Print: UTD-93453 | DOI: 10.5505/tjtes.2017.93453  

Features and Treatment of Gas-forming Synergistic Necrotizing Cellulitis: a Nine Year Retrospective Study

Xiangwei Ling1, Yuanyuan Ye2, Hailei Guo1, Zhengjun Liu1, Weidong Xia1, Cai Lin1
1Department of Burn, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
2Operating Rooms, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China

Background: Many doctors know little about gas-forming synergistic necrotizing cellulitis, so we retrospectively explore it in our study.
Methods: A total of 30 patients diagnosed with gas-forming synergistic necrotizing cellulitis were included between November 2006 and September 2015. 19 patients were given open drainage and 11 patients were given aggressive debridement. The retrospective data analyzed consisted of demographics, APACHE II scores, culture results of pathogens, bleeding amount during the operation, white blood cell and recovery.
Result: The mortality was 26% in open drainage group compared to 73% in aggressive debridement group (p=0.023). There was no statistical difference in APACHE II score before treatment between the two groups(16.6±4.5 score vs 18.1±7.5 score, p=0.511). APACHE II score was significantly higher after treatment in aggressive debridement group (14.2±5.8 score vs 20.1±9.1 score, p=0.038). There were no statistical differences in white blood cell before and after treatment (13.49±5.05×109 cells/L vs 17.46±6.94×109 cells/L, p=0.082; 10.37±3.54×109 cells/L vs 15.47±7.51×109 cells/L, p=0.055). The bleeding amount during the operation was significantly more in aggressive debridement group(315±112ml vs 105±45ml, p=0.000).
Conclusion: For synergistic necrotizing cellulitis treatment, open drainage as early as possible was the most important procedure after admission.

Keywords: Gas-forming infections, Gas gangrene, Synergistic necrotizing cellulitis




Corresponding Author: Cai Lin, China


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