Surgical drainage and debridement of cervical necrotizing fasciitis

Abstract

Abstract: PURPOSE: To investigate the role of surgical drainage and debridement in management of cervical necrotizing fasciitis (CNF). METHODS: We retrospectively reviewed 12 patients (8 males, 4 females) with CNF admitted to the 252nd Hospital of PLA between January 2008 and April 2014. All the patients underwent surgical drainage and debridement. In patients with no clinical improvement, repeated surgical interventions were performed. RESULTS: Surgical drainage and debridement was performed via paralleled transcervical incisions in 10 patients, modified T-shaped incision in 2 patients. In one case with a higher anatomical level in the retropharyngeal space infection, a horizontal incision was made in the posterior pharyngeal wall. One patient with a posterior mediastinal abscess underwent a transthoracic drainage. Of 12 cases, nine had single incision, who demonstrated a stable process and a large number of necrotic fascia tissue fall off from the wound with a shortest time of 5 days and a longest one of 8 days postoperatively. Another 3 patients received 2, 3 and 4 times of surgical intervention respectively because of the worse progress. Three patients died of multiorgans failure with an overall mortality rate of 25.0%. CONCLUSIONS: CNF is an aggressive infection associated with high mortality. Surgical drainage and debridement is an important mean in controlling the progress of the disease. Paralleled transcervical incisions can fully expose the fascial spaces of neck. Repeated surgical intervention is recommended in cases with worse progresses.

Key words: Necrotizing fasciitis, Neck, Surgical drainage, Debridement

CLC Number:

R782.3

CHEN Shu-jun, HAN Xiao-xian, JI Ning, XIAO Jian-rui, CHEN Yu-xuan, WEI Xiao-zong, LIN Xue-mei, CHEN Shuang-min. Surgical drainage and debridement of cervical necrotizing fasciitis[J]. China Journal of Oral and Maxillofacial Surgery, 2015, 13(2): 171-174.

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