title: A special case: treatment of a patient with necrotising fasciitis.
abstract: The case study in this article describes the rapid and accurate diagnosis of a critically ill patient with necrotising fasciitis (NF). Full-thickness patchy skin necrosis of the right thigh, buttock and flank was detected on admission. Prompt radical debridement together with aggressive fluid resuscitation and broad-spectrum antibiotic administration was initiated. Case ascertainment was used to evaluate the effectiveness of a debridement and wound treatment regime,using a monofilament debridement product, negative wound pressure treatment and, after the critical period had ended, a bio-cellulose+ polyhexamethylene biguanide (PHMB) dressing, followed by a collagen dressing. NF after open haemorrhoidectomy represents a life-threatening complication to otherwise healthy patients. Accurate diagnosis, prompt critical care and surgical treatment, together with debridement using the monofilament product and effective wound bed preparation, lead to a successful outcome.
authors.forename: Jolanda
authors.initials: J
authors.lastname: Alblas
authors.forename: Rutger J
authors.initials: RJ
authors.lastname: Klicks
authors.forename: Anneke
authors.initials: A
authors.lastname: Andrlessen
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001458:Bandages; D003646:Debridement / Q000451:nursing*; D019115:Fasciitis, Necrotizing / Q000188:drug therapy / Q000451:nursing* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000451:nursing / Q000601:surgery; D014945:Wound Healing
chemical_list: D000900:Anti-Bacterial Agents