Nekrotizující fasciitida

Necrotizing Fasciitis

The authors present an account of their experience with the diagnosis and treatmentof necrotizing fasciitis at the ENT Clinic of the Faculty Hospital and policlinic Ostrava in 1995-2001.Of 17 patients 16 were cured without postoperative morbidity. One patient died in a serious septicstate with multiorgan failure. Treatment involved multiple longish skin incisions, excisions ofnecrotic tissue with opening of the collar mediastinum and deep fascial cervical spaces, drainagewith wide round drains without primary suture of wounds. In four patients it was necessary toperform urgent tracheotomy on account of oedema of the larynx. Three patients had a ligature andresection of the internal jugular vein on account of thrombophlebitis and in one instance for thesame reason anticoagulant treatment was introduced on account of progressing thrombosis in thebrachiocephalic vein.The authors discuss the etiopathogenetic factors of the disease and methods of surgical andantimicrobial treatment.

Key words:
necrotizing fasciitis, sepsis, drainage.