괴사성 근막염에 대한 임상고찰 = CLINICAL SURVEY OF THE NECROTIZING FASCIITIS

다국어 초록 (Multilingual Abstract)

Necrotizing fasciitis is a fulminating infection of the superficial fascia, resulting in thrombosis of the subcutaneous vessels and necrosis of the underlying tissues.
Many forms of virulent bacteria have been cultured from the lesion, including Vibrio vulnificus, beta-hemolytic streptococci, hemolytic staphylococci, coliforms, enterococci, pseudomonas aeruginosa, and bacteroids.
Usually it follows a cutaneous injury, such as needle puncture, inset bite, or laceration, but sometimes no portal of entry is found.
Early in the course, the area becomes hot, edematous, and red, and as it gradually enlarges a pathognomonic sign develops between the second and the fourth days;the affected skin assumes a blue, dusky tinge. Blisters may be present. The process advances to areas of frank cutaneous necrosis. In the late stages, the involved areas may become painless. The patient is toxic.
There seems to be age predilection, and men are more commonly involved than women, perhaps because of greater liability to trauma.
Early and vigorous surgical debridement is the single most important therapeutic measures. When the would becomes sterile, the split-thickness skin graft is advantageous for covering the wound.
We report seventeen cases of the necrotizing fasciitis.