A rare case of primary necrotising fasciitis of the breast: combined use of hyperbaric oxygen and negative pressure wound therapy to conserve the breast. Review of literature
We report the first case of an otherwise healthy woman exhibiting a primary necrotising fasciitis of the breast, which was treated combining conservative surgery with hyperbaric oxygen (HO) and negative pressure wound therapy (NPWT). A 39‐year‐old woman presented to the emergency room with fever and swelling of her right breast. The physical examination showed oedema and erythema of the breast, with bluish blisters on the lower quadrant. Ultrasound and CT scans showed diffuse oedema of the entire right breast, with subdermal gas bubbles extending to the fascial planes. Few hours later the necrotic area extended regardless an IV antibiotic therapy; a selective debridement of all breast necrotic tissue was performed and repeated 7 days later. The HO was started immediately after the first surgery and repeated daily (2·8 Bar, 120 min) for 18 days and then a NPWT (120–135 mmHg) was applied. Forty‐five days after the last debridement, the breast wound was covered with a full‐thickness skin graft. Several months later, an excellent cosmetic result was observed. This is the first case of primary necrotising fasciitis of the breast treated associating HO and NPWT to surgical debridement only; this combination resulted in a complete recovery with the additional benefit of breast conservation. Such result is discussed in light of the available literature on the treatment of primary necrotising fasciitis of the breast.
Are certain factors associated with the development of postoperative pressure ulcer after liver resection?Wounds
Identify whether incisional (or prophylactic) negative-pressure wound therapy (iNPWT) is associated with reduced wound complications.
Publication date: November 2019Source: European Journal of Surgical Oncology, Volume 45, Issue 11Author(s): Adarsh Shah, Renjit Kurian, Edmund Leung
The objective of this retrospective study in a uniform patient population was to compare the anterior and posterior approaches for 1B-THA in terms of: 1) early mortality rates, 2) early complications, 3) and 90-day re-admission rates, hospital stay lengths, and blood loss.Hypothesis1B-THA in patients younger than 80 years who have an ASA score of 1 or 2 is associated with no early mortality and with low early morbidity rates regardless of whether the anterior or posterior approach is used.Material and methodsA single-centre retrospective comparative design was used to assess 90-day mortality and morbidity rates in consecut...
ConclusionsProphylactic use of NPWT may reduce the incidence of superficial SSI in closed abdominal incisions but has no effect on deep or organ space SSI.
Authors: Namgoong S, Jung SY, Han SK, Kim AR, Dhong ES Abstract Current treatment guidelines for biofilm-associated infections (BAI) recommend repeated sharp/surgical debridement followed by treatment with antimicrobial agents until the wound becomes self-sustaining in terms of a positive wound-healing trajectory. However, complete removal of a biofilm is unlikely, and biofilms reform rapidly. We have treated BAI in patients with chronic diabetic ulcers using a meshed skin graft combined with negative pressure wound therapy (NPWT) immediately after surgical debridement, rather than waiting until the development of ...
Conclusion: The key lessons learned from this experience are being used to develop a new implementation-focused network. Features felt to be especially important for the SCI KMN includes a highly representative governance structure, the use of indicators within an overall evaluation framework and the systematic application of implementation processes with shared learnings supporting each site. PMID: 31573445 [PubMed - in process]
Conditions: Wound Infection; Surgical Site Infection; Surgical Wound; Surgical Incision Interventions: Other: Wound dressings: Conservative dressings; Other: Wound dressings: Prevena dressings; Other: Wound dressings: ciVAC dressings Sponsor: Imperial College London Not yet recruiting
DISCUSSION: The identified preoperative factors and postoperative complications should help guide quality improvement programs. PMID: 31567615 [PubMed - as supplied by publisher]
No abstract available