Necrotizing soft tissue infection of the chest wall.
Necrotizing soft tissue infection (NSTI) of the chest wall is a relatively rare but highly lethal surgical infection which has received little attention in the medical and surgical literature. The data reported are based on a literature review, including a Medline database search, and search of existing bibliographies. Twenty well-documented cases of primary chest wall involvement by NSTI were found. Thirteen patients were male. Patients' ages ranged from 10 weeks to 78 years. Thirteen patients were postoperative (65%). The diagnosis was initially considered in only 3 of the postoperative cases, a cause of significant delays in surgical treatment. Among those who lived long enough for their wounds to close, 2 had secondary healing, 5 experienced delayed skin grafting over the granulating wound, and 1 had skin grafting combined with muscle transfer. Mortality was 60%. Chest wall NSTI is a rapidly spreading, highly lethal infection. A high index of suspicion, early diagnosis, and aggressive approach are essential to its successful treatment.
Department of Surgery, Health Sciences Center, University of Missouri-Columbia School of Medicine, 65212, USA.
J E
JE
Losanoff
B W
BW
Richman
J W
JW
Jones
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D019115:Fasciitis, Necrotizing / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016038:Skin Transplantation; D013896:Thoracic Diseases / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D014945:Wound Healing