Conservative Management of Post Debridement Necrotizing Fasciitis Wounds in Infants
Waseem Humayoun, M Aslam Khan, Hassan Saeed Khan, Mirza M Kafeel, Farhan Gohar, Khalid Saeed
Background: Necrotizing fasciitis is rapidly progressive infection of the subcutaneous tissue and fascia with secondary necrosis. Spread of progressiveness depends upon thickness of subcutaneous layer, and immunological response. Common methods of treating adults includes aggressive debridement, immunoglobulin therapy, and split thickness skin graft. We followed 25 infants having post debridement large surface area of necrotizing fasciitis.
Methods: 25 Patients with Necrotic fasciitis referred from neonatology, pediatric medicine and Pediatric surgery were included in our study from January 2016 till June 2019. In all cases, the presentation was rapidly progressive with necrotic patches developing within 8-12 hours mostly on limbs and trunk area. These patients were managed by aggressive fluid resuscitation, analgesia, broad-spectrum antibiotics, by primary units.
Results: Twenty five Patients up to one year with large surface wounds (15%) were included, 9 from neonatology, 7 from pediatric surgery while 9 were from pediatric medicine and allied. Wound cultures after debridement was done in all cases. 14 patients had polymicrobial bugs while 11 had single bugs. All patients had wound healed by secondary intensions. Wound healing along with patients vitals were observed on weekly basis on outdoor basis.
Conclusion: Conservative treatment in infants with large surface wounds after proper debridement has advantage of cost effectiveness, no donor site morbidity, lesser hospital stay and easy to carry out.
Keywords: Fasciitis, debridement, normal saline dressing.