title: Oxygen free radical and antioxidant status in necrotizing soft tissue infection of the lower extremity; a report of two cases with opposite outcomes.
abstract: Two cases of necrotizing soft tissue infection of the lower extremity were treated concurrently but independently. Multimodal therapy including hip joint disarticulation and hyperbaric oxygen therapy was administered, resulting in opposite outcomes: survival and death. Analysis of the relationships between patient outcome and time-course changes in serum diacron-reactive oxygen metabolites (d-ROMs; an index of oxidative stress), antioxidative potential, and cytokines revealed that serum d-ROMs levels decreased with time, but high serum levels of interleukin-10 (anti-inflammatory cytokine) persisted in the patient who died. These findings may reflect an immunosuppressive status unfavorable to infection prevention. Serum d-ROMs may be a prognostic predictor in necrotizing soft tissue infections.
authors.affiliation: Department of Orthopaedic Surgery, Tohoku University Hospital, Sendai, Japan. koakutsu@med.tohoku.ac.jp
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Koakutsu
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Nomura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamanouchi
authors.forename: Shigeki
authors.initials: S
authors.lastname: Kushimoto
authors.forename: Eiji
authors.initials: E
authors.lastname: Itoi
authors.forename: Yotaro
authors.initials: Y
authors.lastname: Shinozawa
mesh_terms: D000368:Aged; D000975:Antioxidants / Q000378:metabolism*; D016207:Cytokines / Q000097:blood; D005609:Free Radicals; D006801:Humans; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D010100:Oxygen / Q000378:metabolism*; D018461:Soft Tissue Infections / Q000378:metabolism*
chemical_list: D000975:Antioxidants; D016207:Cytokines; D005609:Free Radicals; D010100:Oxygen