Necrotising fasciitis of upper and lower limb: A systematic review

Angoules, Antonios G; Kontakis, George; Drakoulakis, E.G.; Vrentzos, G.; Granick, Mark S.; Giannoudis, Peter V.

doi:10.1016/j.injury.2007.10.030

Cited by 129 publications

(219 citation statements)

References 34 publications

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“…All of our study participants were active servicemembers in combat-field operations at the time of their limb loss. Several things can cause upper-limb loss: congenital conditions [10][11][54][55], non-combatrelated trauma [10,12,[56][57], complications from infections [10,58], dysvascular conditions [3,10], or combatassociated injuries [9]. Surveys from non-combat-associated upper-limb loss populations show similar trends for prosthetic-device use as our population.…”

Section: Discussionmentioning

confidence: 81%

Unilateral upper-limb loss: Satisfaction and prosthetic-device use in veterans and servicemembers from Vietnam and OIF/OEF conflicts

McFarland¹,

Winkler²,

Heinemann³

et al. 2010

JRRD

191

136

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Abstract-Prosthetic use and satisfaction in wounded servicemembers and veterans with unilateral upper-limb loss has not been thoroughly explored. Through a national survey, we enrolled 47 participants from the Vietnam conflict and 50 from Operation Iraqi Freedom/Operation Enduring Freedom (OIF/ OEF) with combat-associated major unilateral upper-limb loss. Upper-limb prosthetic devices were used by 70% of the Vietnam group and 76% of the OIF/OEF group. Mechanical/bodypowered upper-limb devices were favored by the Vietnam group, while a combination of myoelectric/hybrid and mechanical/body-powered devices were favored by the OIF/OEF group. Upper-limb devices were completely abandoned in 30% of the Vietnam and 22% of the OIF/OEF groups. Abandonment was more frequent for transhumeral and more proximal levels (42% of Vietnam and 40% of OIF/OEF) than more distal limb-loss levels. Upper-limb prostheses were rejected because of dissatisfaction with the device by significantly fewer (23%) members of the Vietnam group than the OIF/OEF group (45%) (p < 0.001). Most common reasons for rejection included pain, poor comfort, and lack of functionality. A significant paradigm shift has been noted in the OIF/OEF group, who use a greater number and diversity of upper-limb prostheses than the Vietnam group.

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Section: Discussionmentioning

confidence: 81%

Unilateral upper-limb loss: Satisfaction and prosthetic-device use in veterans and servicemembers from Vietnam and OIF/OEF conflicts

McFarland¹,

Winkler²,

Heinemann³

et al. 2010

JRRD

191

136

View full text Add to dashboard Cite

show abstract

“…Pain disproportionate to local findings may be present and should be a clue to consider NF. [11][12][13][14] In our patient, ampicillin therapy prescribed in the village probably significantly modified the initial clinical picture. Moreover, we presume that antibiotic therapy had rendered many gram-positive organisms nonstainable by the Brown-Brenn method.…”

Section: Discussionmentioning

confidence: 60%

“…[10][11][12][13][14]25 Abnormal inflammatory tests are frequent in cases of NF. Laboratory tests in our case showed a neutrophilia and increased ESR.…”

Section: Discussionmentioning

confidence: 99%

Under Treated Necrotizing Fasciitis Masquerading as Ulcerated Edematous Mycobacterium ulcerans Infection (Buruli Ulcer)

Phanzu

Bafende²,

Imposo³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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We report a case of under treated necrotizing fasciitis (NF) in a 65-year-old woman with diabetes misdiagnosed as Mycobacterium ulcerans infection. She came to the Institut Médical Evangélique (IME) with an extensive painful edematous ulcerated lesion on the dorsum of the right foot and ankle. The diagnosis of Buruli ulcer (BU) was based initially on clinical findings and place of residence (Songololo Territory, the largest known focus of BU in Bas-Congo province). Tissue specimens gave negative results for acid-fast bacilli (AFB), culture, and polymerase chain reaction (PCR) for M. ulcerans. Histopathologic analysis revealed marked necrosis of the lower dermis and subcutaneous tissue. No AFB was found. Later, scattered foci of intracellular gram-positive cocci typical of streptococci were seen. Clinicopathologic correlation of these findings strongly supported the diagnosis of NF. This patient shows the difficulties that may be encountered even in known endemic areas in recognizing BU cases purely on clinical findings.

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“…[2][3][4][5] Necrotizing fasciitis (NF) is a rare, potentially lethal bacterial infection characterized by widespread necrosis of the skin, subcutaneous tissue, and superficial fascia. [6,7] It develops from a bacterial infection, most often group A Streptococcus (GAS). However, mixed aerobic and anaerobic Gram positive (G+) and Gram negative (G-) flora can also be identified.…”

Section: Introductionmentioning

confidence: 99%

Catastrophic necrotizing fasciitis after blunt abdominal trauma with delayed recognition of the coecal rupture – case report

Pecić

Nestorović

Kovačević

et al. 2014

Ulus Travma Acil Cerrahi Derg

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Necrotizing fasciitis (NF) is a rare bacterial infection with dramatic course, characterized by widespread necrosis of the skin, subcutaneous tissue, and superficial fascia which can often lead to death. We present a case of a 27-year-old male with NF. One day after experiencing blunt abdominal trauma caused by falling over bike handlebars, the patient was admitted to a regional hospital and treated for diffuse abdominal pain and large hematoma of the anterior abdominal wall. Due to worsening of general condition, he was referred to our hospital the following day and operated on urgently. Surgery revealed rupture of the coecum with peritonitis and abdominal wall infection. After surgery, fulminant necrotizing fasciitis developed. Antibiotics were prescribed according to wound cultures and subsequent necrectomies were performed. After 25 days, reconstruction of the abdominal wall with skin grafts was obtained. Despite all resuscitation measures including fluids, blood transfusions, and parenteral nutrition, lung infection and MODS caused death 42 days after initial operation. Blunt abdominal trauma can cause the rupture of intestine, and if early signs of peritoneal irritation should present, emergency laparotomy should be performed. Disastrous complication are rare but lethal.

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Necrotising fasciitis of upper and lower limb: A systematic review

Cited by 129 publications

References 34 publications

Unilateral upper-limb loss: Satisfaction and prosthetic-device use in veterans and servicemembers from Vietnam and OIF/OEF conflicts

Unilateral upper-limb loss: Satisfaction and prosthetic-device use in veterans and servicemembers from Vietnam and OIF/OEF conflicts

Under Treated Necrotizing Fasciitis Masquerading as Ulcerated Edematous Mycobacterium ulcerans Infection (Buruli Ulcer)

Catastrophic necrotizing fasciitis after blunt abdominal trauma with delayed recognition of the coecal rupture – case report

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