The use of 5% mafenide acetate solution in the postgraft treatment of necrotizing fasciitis.
Twenty-nine patients with necrotizing fasciitis who were treated with 5% mafenide acetate solution (MAS) as an adjunct after grafting were compared with 45 patients treated without MAS. Statistical analysis of differences was obtained through P values by chi2 testing. The MAS+ (M) and MAS- (C) groups were similar in percent skin deficit (M = 7.5%; C = 9.8%), with the extremity being the most common area of infection. Streptococcus was the most common single organism but polymicrobial infections were the most prevalent (M = 48%; C = 58%). Patients with necrotizing fasciitis treated with MAS had fewer debridements per patient (M = 3.7; C = 5.4), fewer closure procedures (average per patient: M = 1.2; C = 1.73) and a higher percent of first-time closures (83 vs 59%; chi2 = 4.26; P = 0.039). There is a trend toward a lower mortality rate (3.4 vs 13%; chi2 = 2.00; P = 0.158). We conclude that MAS is a useful adjunct in necrotizing fasciitis wound care protocols.
Heinle
E C
EC
University of Southern California School of Medicine, Los Angeles, USA.
Dougherty
W R
WR
Garner
W L
WL
Reilly
D A
DA
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D002056:Burns / Q000175:diagnosis / Q000601:surgery*; D016022:Case-Control Studies; D019115:Fasciitis, Necrotizing / Q000188:drug therapy* / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D008272:Mafenide / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011336:Probability; D012016:Reference Values; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000009:adverse effects*; D012996:Solutions; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects
D012996:Solutions; D008272:Mafenide