Postoperative necrotizing fasciitis in children.

摘要: Necrotizing fasciitis is a rapidly progressive soft tissue infection, involving the skin, subcutaneous tissue, and superficial fascia. It rare but life-threatening complication in postoperative patient. In last 7 years, we have treated four children whom necrotizing developed after appendectomy for ruptured appendix, bilateral inguinal herniorrhaphy, or gastrostomy closure. These patients seven well-described from literature with following surgery form basis of this review. The ages ranged six days to 15 years (ean 4.5 years). There were eight boys three girls. five clean, clean-contaminated, one contaminated surgical procedures. No patient had evidence malignancy diabetes. Two our failure thrive. Only an intraabdominal abscess. ten, infection started abdominal wall; one, chest wall. patients, neutropenia fever, tachycardia, two wound crepitation radiographic gas. Cultures all ten wounds positive bacteria; more than organism. Blood culture results who died only survived. All survivors wide debridement broad-spectrum antibiotics. mortality rate was 45% whole series. death occurred child Down syndrome thrive whose parents refused further therapy. may complicate clean procedures without risk factors. Septicemia late ominous sign. Early antibiotic use are necessary survival. Skin grafting often required coverage these defects.