Document Detail


Limited surgical treatment of suspected necrotizing fasciitis of the upper extremity with a benign clinical presentation.
MedLine Citation:
PMID:  23997598     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
Necrotizing fasciitis is a rapidly evolving, potentially fatal infection. Current recommendations advocate antibiotic administration and early aggressive surgical debridement. Aggressive surgery is associated with significant morbidity, leaving patients with substantial tissue loss and complex wounds. A case of suspected necrotizing fasciitis treated with minimal surgery is described. A previously healthy 48-year-old man presented with increased erythema, swelling and blistering of his left upper extremity. Despite a benign systemic clinical presentation, the hand and forearm were suspicious for necrotizing fasciitis, prompting surgical treatment. Surgical exploration found a significant amount of intradermal and subdermal clear fluid. It was decided to limit the amount of debridement. The diagnosis was Wells syndrome, eosinophilic cellulitis. Treated with steroids, the wounds healed uneventfully. It is important to consider the complete clinical picture before aggressive surgical treatment. A negative history for diabetes, atypical clinical presentation and benign operative findings are suggestive of a more benign diagnosis.
Abstract available from the publisher.
Authors:
Brian Gander; Marc Kaye; Ronit Wollstein
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Canadian journal of plastic surgery = Journal canadien de chirurgie plastique     Volume:  20     ISSN:  1195-2199     ISO Abbreviation:  Can J Plast Surg     Publication Date:  2012  
Date Detail:
Created Date:  2013-09-02     Completed Date:  2013-09-02     Revised Date:  2013-09-04    
Medline Journal Info:
Nlm Unique ID:  9434932     Medline TA:  Can J Plast Surg     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  e44-6     Citation Subset:  -    
Affiliation:
Department of Surgery, Division of Plastic and Reconstructive Surgery;
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