[Staphylococcus lugdunensis necrotizing fasciitis after abdominal dermolipectomy: report of two cases and review of the literature].
Necrotizing dermohypodermitis is a severe and potential fatal infection of soft tissues. We report two cases of 39- and 41-year-old patients operated of abdominal dermolipectomy and liposculpture after bariatric surgery. Because of a body mass index (BMI) less than 35kg/m(2), and trouble of interpretation of the SFAR recommendations, we have not achieved antibiotics. These patients presented an abdominal necrotizing dermohypodermitis at Staphylococcus lugdunensis, requiring wide excision of necrosis in emergency. The suites have been favorable after surgical and medical care. Perineal proximity, skin and subcutaneous peeling appear to be significant risk factors for this pathology. We suggest if case of abdominal dermolipectomy preventive measures in skin preparation and systematic antibiotics regardless of BMI. Indeed, the risk of a necrotizing dermohypodermitis recalls the importance of rigorous prevention and early diagnosis.
Service de chirurgie plastique, reconstructrice et esthétique, chirurgie de la main, centre hospitalo-universitaire Charles-Nicolle, 1, rue de Germont, 76031 Rouen cedex, France. Electronic address: flore.delaunay@yahoo.fr.
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Delaunay
Service de chirurgie plastique, reconstructrice et esthétique, chirurgie de la main, centre hospitalo-universitaire Charles-Nicolle, 1, rue de Germont, 76031 Rouen cedex, France.
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Pegot
Service de chirurgie plastique, reconstructrice et esthétique, chirurgie de la main, centre hospitalo-universitaire Charles-Nicolle, 1, rue de Germont, 76031 Rouen cedex, France.
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Coquerel-Beghin
Service de chirurgie plastique, reconstructrice et esthétique, chirurgie de la main, centre hospitalo-universitaire Charles-Nicolle, 1, rue de Germont, 76031 Rouen cedex, France.
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Aktouf
Service de chirurgie plastique, reconstructrice et esthétique, chirurgie de la main, centre hospitalo-universitaire Charles-Nicolle, 1, rue de Germont, 76031 Rouen cedex, France.
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Auquit-Auckbur
D000005:Abdomen / Q000601:surgery*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003646:Debridement; D019115:Fasciitis, Necrotizing / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D005260:Female; D006801:Humans; D015187:Lipectomy / Q000009:adverse effects*; D009767:Obesity, Morbid / Q000601:surgery; D013203:Staphylococcal Infections / Q000150:complications* / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D057787:Staphylococcus lugdunensis / Q000472:pathogenicity; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents
Abdominal dermolipectomy; Dermohypodermite bactérienne; Dermolipectomie abdominale; Fasciite nécrosante; Necrotizing fasciitis; Staphylococcus lugdunensis