Necrotizing fasciitis at pfannenstiel incision region, case report

Year 2016, Volume: 47 Issue: 2, 48 - 51, 08.05.2016

Fedi Ercan , Osman Balcı Bayram Can

https://doi.org/10.16948/zktb.50161

Abstract

Introduction: Necrotizing fasciitis is severe soft tissue that contain with skin-subcutaneous tissue and fascial necrosis, too. Necrotizing fasciitis usuallay occurs post operation and after blunt trauma, even in minör intramusculer injection areas. To correct diagnosis and to make surgical debridement with reconstructive intervention should be very important. İn spite of early diagnosis and  treatment is high mortality and morbidity. Such as immun system  weakening conditions  diabetes mellitus, liver and kidney failure, various malignancy, chronic alcohol use, peripheral vasculer diseases, conditions  provoke Necrotizing fasciitis  mortality of Necrotizing fasciitis  ratio is %20-%50.

Case: Necrotizing fasciitis  event is presented that occur  after cancer gynecological surgery with phannenstiel cut in this article.

Conclusion: Basic of treatment is early diagnosis  and wide spectrum antibiotic treatment, to make debridement recurrent until intact tissue catch up necrosis tissue.

Keywords

Necrotizing fasciitis, Hysterectomy, Pfannenstiel incision, Abdominal wall.

Pfannenstiel insizyon bölgesinde nekrotizan fasiit, olgu sunumu

Abstract

Giriş: Nekrotizan fasiit (NF), cilt-ciltaltı dokusu ile birlikte fasya nekrozunu da içine alan ağır seyirli subkutan yumuşak doku enfeksiyonudur. Genellikle cerrahi girişim ya da künt travmalar sonrası görülmektedir, ancak intramusküler injeksiyon gibi minor girişim bölgelerinde dahi görülebilmektedir. Doğru tanı koyulması ve gerekli cerrahi debridman ile rekonstrüktif cerrahi işlemlerin acilen yapılması çok önemlidir. Ancak, bazen erken tanı ve tedaviye rağmen mortalite ve morbiditesi yüksektir. Diyabetes mellitus, karaciğer ve böbrek yetmezliği, çeşitli malignensiler, kronik alkol kullanımı, periferik vasküler hastalıklar ve ileri yaş gibi immün sistemi zayıflatan haller bu klinik tablo için zemin hazırlayan durumlardır. Genel olarak mortalite oranı %20-50 kadardır.

Olgu: Burada Pfannenstiel insizyon ile yapılan jinekolojik kanser cerrahisi sonrası gelişen bir NF olgusu sunulmaktadır.

Sonuç: NF için tedavinin temelini erken tanı, geniş spektrumlu antibiyotik tedavisi, geride nekrotik doku kalmayacak şekilde sağlam dokulara kadar ve gerektiğinde tekrarlanan debridman oluşturur.

Keywords

nekrotizan fasiit, histerektomi, pfannenstiel insizyon, batın duvarı

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