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Hoại tử nhiễm trùng mô mềm

Hoại tử fasciitis là một nhiễm trùng mô mềm hiếm gặp và thường gây tử vong liên quan đến các lớp fascial bề mặt các chi, bụng, hoặc đáy chậu. Hoại tử fasciitis thường bắt đầu với chấn thương, tuy nhiên, sự kiện kích động có thể có vẻ vô hại như đụng dập đơn giản, ghi đĩa nhỏ, hoặc côn trùng cắn. | Necrotizing Soft-Tissue Infections Roger A. Fontes Jr MD Christian M. Ogilvie MD and Theodore Miclau MD Abstract Necrotizing fasciitis is a rare and often fatal soft-tissue infection involving the superficial fascial layers of the extremities abdomen or perineum. Necrotizing fasciitis typically begins with trauma however the inciting event may be as seemingly innocuous as a simple contusion minor burn or insect bite. Differentiating necrotizing infections from common soft-tissue infections such as cellulitis and impetigo is both challenging and critically important. A high degree of suspicion may be the most important aid in early diagnosis. Prompt diagnosis is imperative because necrotizing infections typically spread rapidly and can result in multiple-organ failure adult respiratory distress syndrome and death. Although group A Streptococcus is the most common bacterial isolate a polymicrobial infection with a variety of Gram-positive Gram-negative aerobic and anaerobic bacteria is more common. Orthopaedic surgeons are often the first physicians to evaluate patients with such infections and therefore need to be familiar with this potentially devastating disease and its management. Prompt diagnosis immediate administration of broad-spectrum antibiotic coverage and emergent aggressive surgical debridement of all compromised tissues are critical to reduce the morbidity and mortality of these rapidly progressing infections. J Am Acad Orthop Surg 2000 8 151-158 Necrotizing soft-tissue infections have been recognized for centuries. Hippocrates vividly described the disease in the 5th century BC as follows ÒThe erysipelas would quickly spread in all directions. Flesh sinews and bones fell away in great quantities.Ó Necrotizing soft-tissue infections were subsequently designated as Òstreptococcal gangrene Ó Òphage-dena Ó and Òphagedena gangreno-sum.Ó The first report of necrotizing fasciitis in the United States was made in 1871 by Joseph Jones 1 a Confederate Army .