Necrotizing fasciitis secondary to enterocutaneous fistula: three case reports

World J Gastroenterol. 2014 Jun 28;20(24):7988-92. doi: 10.3748/wjg.v20.i24.7988.

Abstract

Necrotizing fasciitis (NF) is an uncommon, rapidly progressive, and potentially fatal infection of the superficial fascia and subcutaneous tissue. NF caused by an enterocutaneous fistula has special clinical characters compared with other types of NF. NF caused by enterocutaneous fistula may have more rapid progress and more severe consequences because of multiple germs infection and corrosion by digestive juices. We treated three cases of NF caused by postoperative enterocutaneous fistula since Jan 2007. We followed empirically the principle of eliminating anaerobic conditions of infection, bypassing or draining digestive juice from the fistula and changing dressings with moist exposed burn therapy impregnated with zinc/silver acetate. These three cases were eventually cured by debridement, antibiotics and wound management.

Keywords: Diagnosis; Enterocutaneous fistula; Necrotizing fasciitis; Treatment.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Infective Agents, Local / therapeutic use
  • Bandages
  • Combined Modality Therapy
  • Debridement
  • Drainage
  • Fasciitis, Necrotizing / diagnosis
  • Fasciitis, Necrotizing / microbiology*
  • Fasciitis, Necrotizing / therapy
  • Humans
  • Intestinal Fistula / diagnosis
  • Intestinal Fistula / microbiology*
  • Intestinal Fistula / therapy
  • Male
  • Middle Aged
  • Postoperative Complications / diagnosis
  • Postoperative Complications / microbiology*
  • Postoperative Complications / therapy
  • Reoperation
  • Skin Transplantation
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Anti-Infective Agents, Local