Objective: To develop an optimal algorithm for complex treatment of patients with necrotic soft tissue infections (NSTI).
Material And Methods: The study included 114 patients with NSTI who were treated between 2016 and 2021. We analyzed treatment outcomes in 2 groups: retrospective (=43) with traditional approaches to purulent surgery (drainage of necrotic foci, local therapy with iodophores and water-soluble ointments, antibacterial and detoxification therapy, delayed skin grafting) and prospective (=71) with active surgical treatment and modern algorithm based on a differentiated approach and high-tech methods (vacuum therapy, hydrosurgical treatment of wounds, early skin grafting and extracorporeal hemocorrection).
Results: The main group was characterized by shorter phase I of the wound process by 7.1±2.1 days, earlier relief of symptoms of systemic inflammatory response by 4.2±1.4 days, shorter hospital-stay by 7.7±2.2 days and lower mortality by 15%.
Conclusion: Early surgery and integrated approach including active surgical strategy, early skin grafting and intensive care with extracorporeal detoxification are necessary to improve the outcomes in patients with NSTI. These measures are effective to eliminate purulent-necrotic process, reduce mortality and hospital-stay.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.17116/hirurgia202306134 | DOI Listing |
Ann Plast Surg
December 2024
Division of Plastic Surgery, University of Texas Medical Branch, Galveston, TX.
Introduction: The reverse sural flap (RSF) is a random-type, pedicled flap based on sural artery perforators indicated for traumatic lower-extremity wounds. The RSF has demonstrated comparable results to free flap placement in the adult population for reconstruction of distal third defects, but few reports describe its application and outcomes in the pediatric population.
Methods: We investigated RSF application in pediatric patients (<18 years of age) through systematic review and meta-analysis.
Cureus
December 2024
Plastic and Reconstructive Surgery, St. Marianna University School of Medicine, Kawasaki, JPN.
Background: Recently, autologous cultured fibroblast and platelet-rich plasma (PRP) therapies have been attempted for skin rejuvenation. Unlike PRP, grafted fibroblasts not only produce connective tissue but also influence the surrounding environment through a paracrine effect. Fibroblast-derived cytokines interact with and are modulated by neighboring tissue-constituting cells.
View Article and Find Full Text PDFMicrosurgery
January 2025
Pediatric Hand Surgery and Microsurgery, Barcelona Children's Hospital, HM Nens, HM Hospitales, Barcelona, Spain.
Background: Pediatric first web space contractures of the hand can lead to disability in hand function. Several techniques have been proposed for treating this condition. Recently, a new technique involving the first palmar cutaneous flap was described in a cadaveric study.
View Article and Find Full Text PDFCell Transplant
January 2025
Department of Translational Research & Cellular Therapeutics, Arthur Riggs Diabetes & Metabolism Research Institute, City of Hope, Duarte, CA, USA.
Herein, we characterized the percentage of tacrolimus to the combined sirolimus and tacrolimus trough levels (tacrolimus %) observed during islet transplant-associated immune suppression therapy with post-transplant skin cancer. Although trough levels of tacrolimus and sirolimus were not different ( = 0.79, 0.
View Article and Find Full Text PDFCarbohydr Polym
March 2025
School of Materials Science and Engineering, Tongji University, Shanghai 201804, PR China. Electronic address:
Skin grafting techniques are widely used for large burns, trauma, and various acute and chronic wounds, contributing greatly to the repair of traumatic tissue. However, donor site repair and regeneration are often neglected, resulting in infection and delayed healing. Therefore, it is crucial to reduce the rate of donor site infection and improve the speed and quality of healing.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!