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The Clinical Investigation of Necrotizing Fasciitis in Burn Center
Journal of Korean Burn Society 2019;22(2):66-70
Published online December 1, 2019
© 2019 Journal of Korean Burn Society.

Euimyung Kim, M.D., Jin Woo Chun, M.D.1, Young Min Kim, M.D.1, Jae Chul Yoon, M.D.1, Hae Jun Lim, M.D.1, Yong Suk Cho, M.D.1, Dohern Kim, M.D.1, Jun Hur, M.D.1 and Wook Chun, M.D.1

Department of Surgery, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, 1Department of Burn Surgery, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
Correspondence to: 전욱, 서울시 영등포구 버드나루로 7길 12 ㉾ 07247, 한림대학교한강성심병원 화상외과
Tel: 02-2639-5001, Fax: 02-2633-7571
E-mail: chun0414@hallym.or.kr
Received October 30, 2019; Revised November 27, 2019; Accepted November 28, 2019.
Abstract
Purpose: The necrotizing fasciitis is a terrifying infectious disease that can rapidly spreads to surrounding tissues when fascia is infected and it can cause sepsis to death if not properly diagnosed and treated. The purpose of this study is to investigate the characteristics, causes, and treatment methods of necrotizing fasciitis in Korea through reviewing patients admitted to our burn center.
Methods: 21 patients with necrotizing fasciitis were selected for this study among those inpatients with electronic medical records (EMR) admitted to Hallym University Hangang Sacred Heart Medical Center from Jan 1, 2008 to June 30, 2019. The medical records and wound photos of those 21 selected subjects were reviewed.
Results: There were 13 male and 8 female patients and mean age was 58.76 years old. 13 of 21 subjects were survived and 8 died (38% mortality rate). The surgical treatments performed were I&D, fasciotomy, debridement, allograft, burring, STSG, flap, and amputation. The most common causes were burns in 9 subjects (6 contact burns) and cellulitis occurred on skins in 5 subjects. And other various causes were observed as fournier's gangrene, stab wound, intramuscular injection, tumor and bleu toe syndrome (toe necrosis). The infected areas were 11 feet and legs, 7 hips, 3 abdomen and trunk in 21 subjects. Of the 8 deaths, 3 were infected in feet and legs, 2 were infected in hips, and 2 were infected in abdomen and trunk. As for underlying diseases, 12 patients with hypertension or diabetes were the highest and others such as cancer and stroke were found.
Conclusion: The only method to increase the survival rate is to ‘suspect’ the disease as much as possible and perform early extensive excision. It is advisable to treat the disease by the burn center to properly provide adequate and optimal wound management, infection control, medical care and nutritional supports.
Keywords : Necrotizing fasciitis, Burn center, High mortality


December 2019, 22 (2)
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