Document Detail


Anesthetic implications of cervicofacial necrotizing fasciitis.
MedLine Citation:
PMID:  14507567     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cervicofacial necrotizing fasciitis is a necrotizing soft tissue infection of face and neck spreading at the level of fascia. It has been described as a putrid ulcer, phagedaena, and hospital gangrene. It has a high mortality rate, and presents a challenge to anesthesiologists who must secure an airway to deliver anesthesia safely. We report a case of cervicofacial necrotizing fasciitis in which the patient underwent repeated radical surgical debridement of face and neck, including a mandibulectomy. These critically ill patients often present with sepsis and multiple system organ failure. Extensive preoperative evaluation, invasive monitoring, and possibly the use of vasopressors and inotropes are essential in treating these patients. The tracheas of these patients should remain intubated after initial debridement. Tracheostomy should be performed early. Antibiotic therapy, nutritional support, early debridement, and hyperbaric oxygen therapy all help to decrease mortality in these patients.
Authors:
Mehmood A Durrani; John F Mansfield
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of clinical anesthesia     Volume:  15     ISSN:  0952-8180     ISO Abbreviation:  J Clin Anesth     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-09-25     Completed Date:  2004-02-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8812166     Medline TA:  J Clin Anesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  378-81     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, West Virginia University Hospital, Morgantown, WV 26506-9134, USA. Mehmoodd@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Anesthesia, Inhalation*
Debridement
Diabetes Mellitus, Type 2 / complications
Face / pathology,  surgery*
Fasciitis, Necrotizing / pathology,  surgery*
Fatal Outcome
Humans
Kidney Failure, Chronic / complications
Male
Mandible / surgery
Middle Aged
Neck / pathology,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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