Wednesday, June 22, 2011

SURGICAL INFECTIONS



NECROTISING FASCITIS


B haemolytic Streptococci and Coagulase positive staphlococci
cause spreading life-threatening infection which involves
superficial fascia, with an extreme systemic toxicity.

Most soft tissue infections are caused by a mixed infection of
aneorobic (clostrodia) and gram positive bacteria.

These infection must be recognised early.
There is skin necrosis and bullae.
In early cases there is only cellulite mental confusion and toxicity
are indication for surgical treatment ofdebridment of all necrosed tissue.

A majority of cases have occured inside the hospital following
minor trauma or following abrasions, cuts or boils.
Chief diagnostic indicator is a superficial and widespread fascial
necrosis.
- Cellulitis and oedema are in evidence.
- The involved skin is pale-red without any distinct border,
there are blisters.
Diagnosis is made by observation of bacteria in the
serosanguinous exudate.
There is a marked increase in white cell count.


TREATMENT
1. Multiple linear incisions with debridement
2. Use of a combination of Clindamycin and Ampicillin

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