Abstract | BACKGROUND: Necrotising fasciitis (NF) is a devastating disease with considerable mortality and morbidity, and early aggressive surgical debridement of devitalised necrotic tissues has traditionally been advocated. METHODS: We describe three patients who were referred from other units several weeks after developing periocular necrotising fasciitis; in all the three, the disease had been managed medically without surgical debridement, with apparent 'stalling' of the inflammatory process despite persistent necrotic periocular tissue. RESULTS: Following 'elective debridement' of the devitalised tissues and reconstruction with local flaps, all achieved a satisfactory aesthetic result. DISCUSSION: The role of host genetic determinants, polarised cytokine responses, and early, effective medical treatment in patients with atypical 'disease phenotypes' in NF are discussed.
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Authors | A Mutamba, D H Verity, G E Rose |
Journal | Eye (London, England)
(Eye (Lond))
Vol. 27
Issue 3
Pg. 432-7
(Mar 2013)
ISSN: 1476-5454 [Electronic] England |
PMID | 23412558
(Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Aged
- Anti-Bacterial Agents
(therapeutic use)
- Blepharoplasty
- Debridement
- Eye Infections, Bacterial
(drug therapy, genetics, surgery, therapy)
- Eyelid Diseases
(drug therapy, genetics, surgery, therapy)
- Fasciitis, Necrotizing
(drug therapy, genetics, surgery, therapy)
- Female
- Genetic Determinism
- Humans
- Male
- Middle Aged
- Orbital Diseases
(drug therapy, genetics, surgery, therapy)
- Pseudomonas Infections
(drug therapy, genetics, surgery, therapy)
- Streptococcal Infections
(drug therapy, genetics, surgery, therapy)
- Surgical Flaps
- Th1 Cells
(immunology)
- Visual Acuity
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