A systematic review of necrotising fasciitis in children from its first description in 1930 to 2018

Necrotising fasciitis is a rapidly progressing soft-tissue infection with a low incidence that carries a relevant risk of morbidity and mortality. Although necrotising fasciitis is often fatal in adults, its case fatality rate seems to be lower in children. A highly variable clinical presentation makes the diagnosis challenging, which often results in misdiagnosis and time-delay to therapy

Factors influencing the length of the recovery period after blepharoplasty: a review of the latest data

Introduction and purpose Blepharoplasty is a surgical procedure aimed at restoring the functionality and/or aesthetics of the eyelids. The aim of the study is to draw attention to the factors influencing the recovery period at successive stages of therapeutic procedures. A brief description of the state of knowledge: Preoperative consultation is important in selecting patients, planning surgical procedures, identifying potential complications and meeting patients' expectations. In patients with hypertension, diabetes, smoking, and anticoagulant treatment, a worse scar assessment, longer recovery period and more complications have been observed. Patients who have undergone refractive surgery within the last 6 months are not suitable candidates for blepharoplasty. Nutrition status has a significant impact on wound healing and tissue repair after aesthetic medicine procedures. The use of continuous sutures compared to tissue glue results in similar wound healing time and postoperative discomfort level. Postoperative wound care is essential for the healing process. Electrostimulation of the wound does not accelerate edema reduction. We have focused on many complications, such as swelling, bleeding, infections, eyelid malposition, dry eye syndrome, wound dehiscence, ways to cope with these problems, and the role of lasers.  Summary (conclusions): Important is the proper preparation of the patient for the procedure. A detailed interview and examination influence therapeutic decisions, allowing the doctor to choose the most optimal treatment methods that will shorten the recovery time. Blepharoplasty is one of the most commonly performed aesthetic procedures, so we propose the development of publicly accessible standards that should be included in the initial interview

Fatal infective necrotising fasciitis: Complication following Naja nigricincta nigricincta bite (western barred spitting cobra/zebra snake)

Wound infections following cytotoxic snakebites are common. Bites from Naja nigricincta nigricincta (an African spitting cobra) usually present as severe dermonecrosis spreading within the subdermal fascia layer. Primary infections can follow inoculation of the snake’s oral flora during the bite, worsening the dermonecrosis into infective necrotising fasciitis. We report the case of a 2½-year-old boy who presented with infective (Proteus vulgaris) necrotising fasciitis after an N. n. nigricincta bite, resulting in multiple-organ failure and death. A P. vulgaris with the same antibiotic profile was cultured from the mouth of the snake

Microbiology and management of soft tissue and muscle infections

AbstractThis review summarizes the microbiological aspects and management of soft tissue and muscle infections. The infections presented are: impetigo, folliculitis, furunculosis and carbuncles, cellulitis, erysipelas, infectious gangrene (includes necrotizing fasciitis or streptococcal gangrene, gas gangrene or clostridium myonecrosis, anaerobic cellulites, progressive bacterial synergistic gangrene, synergistic necrotizing cellulitis or perineal phlegmon, gangrenous balanitis, and gangrenous cellulitis in the immunocompromised patient), secondary bacterial infections complication skin lesions, diabetic and other chronic superficial skin ulcers and subcutaneous abscesses and myositis. These infections often occur in body sites or in those that have been compromised or injured by foreign body, trauma, ischemia, malignancy or surgery. In addition to Group A streptococci and Staphylococcus aureus, the indigenous aerobic and anaerobic cutaneous and mucous membranes local microflora usually is responsible for polymicrobial infections. These infections may occasionally lead to serious potentially life-threatening local and systemic complications. The infections can progress rapidly and early recognition and proper medical and surgical management is the cornerstone of therapy

Volume 30, issue 1

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research. Visit the journal website at http://canjsurg.ca/ for more.https://ir.lib.uwo.ca/cjs/1215/thumbnail.jp

Factors influencing the length of the recovery period after blepharoplasty: a review of the latest data

Introduction and purpose Blepharoplasty is a surgical procedure aimed at restoring the functionality and/or aesthetics of the eyelids. The aim of the study is to draw attention to the factors influencing the recovery period at successive stages of therapeutic procedures. A brief description of the state of knowledge: Preoperative consultation is important in selecting patients, planning surgical procedures, identifying potential complications and meeting patients' expectations. In patients with hypertension, diabetes, smoking, and anticoagulant treatment, a worse scar assessment, longer recovery period and more complications have been observed. Patients who have undergone refractive surgery within the last 6 months are not suitable candidates for blepharoplasty. Nutrition status has a significant impact on wound healing and tissue repair after aesthetic medicine procedures. The use of continuous sutures compared to tissue glue results in similar wound healing time and postoperative discomfort level. Postoperative wound care is essential for the healing process. Electrostimulation of the wound does not accelerate edema reduction. We have focused on many complications, such as swelling, bleeding, infections, eyelid malposition, dry eye syndrome, wound dehiscence, ways to cope with these problems, and the role of lasers.  Summary (conclusions): Important is the proper preparation of the patient for the procedure. A detailed interview and examination influence therapeutic decisions, allowing the doctor to choose the most optimal treatment methods that will shorten the recovery time. Blepharoplasty is one of the most commonly performed aesthetic procedures, so we propose the development of publicly accessible standards that should be included in the initial interview