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Necrotizing soft tissue infection after laparoscopic surgery
Author(s) -
Mohammadhosseini Bijan,
Vaji Mehrdad Baghaei
Publication year - 2008
Publication title -
surgical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.109
H-Index - 10
eISSN - 1744-1633
pISSN - 1744-1625
DOI - 10.1111/j.1744-1633.2008.00414.x
Subject(s) - medicine , fasciitis , surgery , soft tissue , debridement (dental) , pancreatitis , diabetes mellitus , fascia , laparoscopic surgery , mortality rate , laparoscopy , endocrinology
Necrotizing Fasciitis (NF) is a rare infection of the fascia and subcutaneous tissue; it has a high associated mortality rate. This paper reports the first case of fatal NF after an uneventful laparoscopic cholecystectomy. The patient had no predisposing factors or gastrointestinal complications. A PubMed/Medline database search (1966–2006) identified 13 reports of NF after laparoscopic surgery. Factors such as obesity, diabetes mellitus, alcohol, substance abuse, chronic pancreatitis, bowel perforation, leaking cystic duct, and trocar site herniation were found to be predisposing factors or complications of laparoscopic surgery. The mortality rate of NF was reported to be 23%. Infectious causes of disease such as streptococcal and staphylococcal species, enterococci and enterobacteriaceae are common culture isolates. Early diagnosis and an aggressive approach to treatment with initial debridement followed by planned repeat debridements in conjunction with antibiotics and nutritional support remains the mainstay of treatment. The Laboratory Risk Indicator for Necrotizing Fasciitis score may be a good tool for distinguishing NF from other soft tissue infections.