BACKGROUND Necrotizing fasciitis is a fulminant necrotizing soft tissue disease with a high fatality rate.It always starts with impact on the deep fascia rapidly and might result in secondary necrosis of the subcutane...BACKGROUND Necrotizing fasciitis is a fulminant necrotizing soft tissue disease with a high fatality rate.It always starts with impact on the deep fascia rapidly and might result in secondary necrosis of the subcutaneous tissue,fascia,and muscle.Thus,timely and multiple surgical operations are needed for the treatment.Meanwhile,the damage of skin and soft tissue caused by multiple surgical operations may require dermatoplasty and other treatments as a consequence.CASE SUMMARY Here,we report a case of 50-year-old male patient who was admitted to our hospital with symptoms of necrotizing fasciitis caused by cryptoglandular infection in the perianal and perineal region.The symptoms of necrotizing fasciitis,also known as the cardinal features,include hyperpyrexia,excruciatingly painful lesions,demonstration gas in the tissue,an obnoxious foul odor and uroschesis.The results of postoperative pathology met the diagnosis.Based on the premise of complete debridement,multiple incisions combined with thread-dragging therapy(a traditional Chinese medicine therapy)and intensive supportive therapies including comprising antibiotics,nutrition and fluids were given.The outcome of the treatment was satisfactory.The patient recovered quickly and achieved ideal anal function and morphology.CONCLUSION Timely and effective debridement and multiple incisions combined with thread-dragging therapy are an integrated treatment for necrotizing fasciitis.展开更多
Objective To investigate the clinical effects of thread-dragging therapy on gangrene of non-ischemic diabetic foot ulcers(NIDFU).Methods A total of 136 patients with NIDFU were recruited from the Department of Periphe...Objective To investigate the clinical effects of thread-dragging therapy on gangrene of non-ischemic diabetic foot ulcers(NIDFU).Methods A total of 136 patients with NIDFU were recruited from the Department of Peripheral Vascular Surgery,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine between June 21,2021 and February 1,2023,and randomized into an intervention group and a control group,with 68 cases in each group.Both groups received basic treatment.The intervention group was treated with thread-dragging therapy,while the control group was treated with debridement combined with routine dressing changes after surgery.Both groups were treated continuously for 2 months.The amputation rates and changes in the ulcer area were compared between the groups.The inflammatory response index including peripheral white blood cells(WBCs),neutrophil percentage(NEUT%),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),procalcitonin(PCT),and interleukin 6(IL-6)were compared between the two groups.Results After treatment,the ulcer areas in the intervention group were significantly smaller than that of the control group(8.50±3.88 cm^(2) vs.10.11±4.61 cm^(2),P<0.05).The amputation rates of the two groups were not statistically significant(4.4%vs.5.9%,P>0.05).Differences of WBCs count,CRP,and ESR before and after therapy in the intervention group were better than the control group(P<0.05).However,there were no significant differences in changes of NEUT%,PCT,and IL-6 between the two groups(P>0.05).Conclusion Thread-dragging therapy may be effective in the treatment of NIDFU,with the additional advantages of less tissue damage after healing.(Registration No.ChiCTR2100047496)展开更多
基金the Young Talent Program of LongHua Hospital Shanghai University of Traditional Chinese Medicine,No.RC-2019-01-01and the Shanghai Three-year Action Plan of Further Accelerated Development in Traditional Chinese Medicine,No.ZY(2018-2020)-CCCX-1007.
文摘BACKGROUND Necrotizing fasciitis is a fulminant necrotizing soft tissue disease with a high fatality rate.It always starts with impact on the deep fascia rapidly and might result in secondary necrosis of the subcutaneous tissue,fascia,and muscle.Thus,timely and multiple surgical operations are needed for the treatment.Meanwhile,the damage of skin and soft tissue caused by multiple surgical operations may require dermatoplasty and other treatments as a consequence.CASE SUMMARY Here,we report a case of 50-year-old male patient who was admitted to our hospital with symptoms of necrotizing fasciitis caused by cryptoglandular infection in the perianal and perineal region.The symptoms of necrotizing fasciitis,also known as the cardinal features,include hyperpyrexia,excruciatingly painful lesions,demonstration gas in the tissue,an obnoxious foul odor and uroschesis.The results of postoperative pathology met the diagnosis.Based on the premise of complete debridement,multiple incisions combined with thread-dragging therapy(a traditional Chinese medicine therapy)and intensive supportive therapies including comprising antibiotics,nutrition and fluids were given.The outcome of the treatment was satisfactory.The patient recovered quickly and achieved ideal anal function and morphology.CONCLUSION Timely and effective debridement and multiple incisions combined with thread-dragging therapy are an integrated treatment for necrotizing fasciitis.
基金Supported by the Health and Family Planning Research Project of Pudong New Area Health Committee,Shanghai,China(No.PW2020E-4)。
文摘Objective To investigate the clinical effects of thread-dragging therapy on gangrene of non-ischemic diabetic foot ulcers(NIDFU).Methods A total of 136 patients with NIDFU were recruited from the Department of Peripheral Vascular Surgery,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine between June 21,2021 and February 1,2023,and randomized into an intervention group and a control group,with 68 cases in each group.Both groups received basic treatment.The intervention group was treated with thread-dragging therapy,while the control group was treated with debridement combined with routine dressing changes after surgery.Both groups were treated continuously for 2 months.The amputation rates and changes in the ulcer area were compared between the groups.The inflammatory response index including peripheral white blood cells(WBCs),neutrophil percentage(NEUT%),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),procalcitonin(PCT),and interleukin 6(IL-6)were compared between the two groups.Results After treatment,the ulcer areas in the intervention group were significantly smaller than that of the control group(8.50±3.88 cm^(2) vs.10.11±4.61 cm^(2),P<0.05).The amputation rates of the two groups were not statistically significant(4.4%vs.5.9%,P>0.05).Differences of WBCs count,CRP,and ESR before and after therapy in the intervention group were better than the control group(P<0.05).However,there were no significant differences in changes of NEUT%,PCT,and IL-6 between the two groups(P>0.05).Conclusion Thread-dragging therapy may be effective in the treatment of NIDFU,with the additional advantages of less tissue damage after healing.(Registration No.ChiCTR2100047496)
