title: Postoperative synergistic gangrene after spinal fusion.
abstract: METHODS
  A case of synergistic necrotizing gangrenous fasciitis after spinal surgery is reported.
  
  
  OBJECTIVE
  To describe this unusual complication, explain the rationale of treatment, and increase awareness of this serious postoperative complication.
  
  
  BACKGROUND
  Although several cases of postoperative synergistic necrotizing fasciitis have been reported, there are no previously reported cases of this condition after spinal surgery.
  
  
  METHODS
  A rapidly progressive necrotizing spinal wound infection after fusion for degenerative disc disease was treated in a 39-year-old man.
  
  
  RESULTS
  The infection was successfully treated with serial debridements, appropriate antibiotics, and hyperbaric wound oxygenation.
  
  
  CONCLUSIONS
  The authors suggest adherence to the fundamental principles of treatment including radical surgical debridement and appropriate antibiosis for necrotizing gangrene after spinal surgery. In evaluation of aggressive spinal wound infections, diagnosis of synergistic necrotizing fasciitis should be kept in mind. Although hyperbaric wound oxygenation was implemented as an adjunct and appeared to aid in controlling the infection, its effect on outcome is not clear.
authors.affiliation: Department of Orthopaedic Surgery, New Jersey Medical School, UMDNJ-Newark, New Jersey 07103, USA.
authors.forename: C P
authors.initials: CP
authors.lastname: Kauffman
authors.forename: C M
authors.initials: CM
authors.lastname: Bono
authors.forename: P P
authors.initials: PP
authors.lastname: Vessa
authors.forename: K G
authors.initials: KG
authors.lastname: Swan
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001416:Back Pain / Q000382:microbiology / Q000601:surgery*; D003646:Debridement; D017586:Diskectomy; D004927:Escherichia coli Infections / Q000188:drug therapy; D019115:Fasciitis, Necrotizing / Q000628:therapy*; D005734:Gangrene / Q000628:therapy*; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D011183:Postoperative Complications / Q000382:microbiology*; D013123:Spinal Fusion; D013290:Streptococcal Infections / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents