title: [Postoperative quality of life of patients with a bacterial necrotizing dermis-hypodermitis or necrotizing fasciitis, a ten-year study].
abstract: BACKGROUND
  Bacterial necrotizing dermis-hypodermitis and necrotizing fasciitis (BNDH-NF) are serious life-threatening soft-tissue infections. The object is to evaluate the quality of life (QOL) of patients who have been operated in our plastic surgery departement.
  
  
  METHODS
  This is a retrospective study of cases who have been treated at Nancy University Hospital between 2005 and 2014. We analyzed the perioperative data (demographic, clinical, bacteriological), the surgical data (excision, reconstruction) and the follow up data (consequences, mortality). The quality of life was assessed by the Short-Form 36 score, and the patients' satisfaction was assessed by a four-level scale.
  
  
  RESULTS
  We analyzed 23 patients with an average age of 60 years (28-84 years). The main comorbidities were diabetes (43 %) and obesity (39 %). The average number of surgical excision was about 1.9 (1-5) and the average excised body surface area was about 5 % (1-16 %). The short-term mortality was about 17 %. The mortality rate has been statistically correlated with the surgically excised body surface area (short-term 95 days: P=0.02; and long-term: P=0.003). The statistical analysis has shown a strong relative linear relationship between number of surgical excision and the physical score of QOL (P<0.001), between number of surgical excision and mental score of QOL (P=0.032), and between age and physical score of QOL (P≤0.021). The statistical analysis has also shown a strong relative linear relationship between E. coli infections and physical score of QOL (P=0.01). The percentage of patients' satisfaction in our study was evaluated at 86 %.
  
  
  CONCLUSIONS
  We have found that multiple surgical excisions, an advanced age of patients and E. coli infections have been associated with poor QOL. The mortality rate increased in relation with the importance of excised body surface. In spite of the gravity of these infections, our patients were satisfied of their treatment.
authors.affiliation: Service de chirurgie maxillofaciale, plastique, reconstructrice et esthétique, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France; Faculté de médecine, université de Lorraine, 54000 Nancy, France. Electronic address: thomas.brengardbresler@gmail.com.
authors.forename: T
authors.initials: T
authors.lastname: Brengard-Bresler
authors.affiliation: Service de chirurgie maxillofaciale, plastique, reconstructrice et esthétique, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France; Faculté de médecine, université de Lorraine, 54000 Nancy, France.
authors.forename: A
authors.initials: A
authors.lastname: De Runz
authors.affiliation: Mapi Group, Health Economics and Outcomes Research, 41, rue des Trois-Fontanot, 92000 Nanterre, France.
authors.forename: F
authors.initials: F
authors.lastname: Bourhis
authors.affiliation: Service de chirurgie maxillofaciale, plastique, reconstructrice et esthétique, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France; Faculté de médecine, université de Lorraine, 54000 Nancy, France.
authors.forename: H
authors.initials: H
authors.lastname: Mezzine
authors.affiliation: Service de chirurgie maxillofaciale, plastique, reconstructrice et esthétique, CHR de Metz-Thionville, 1, allée du Château, 57085 Metz, France.
authors.forename: G
authors.initials: G
authors.lastname: Khairallah
authors.affiliation: Service de chirurgie maxillofaciale, plastique, reconstructrice et esthétique, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France; Faculté de médecine, université de Lorraine, 54000 Nancy, France.
authors.forename: M
authors.initials: M
authors.lastname: Younes
authors.affiliation: Service de chirurgie maxillofaciale, plastique, reconstructrice et esthétique, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France; Faculté de médecine, université de Lorraine, 54000 Nancy, France.
authors.forename: M
authors.initials: M
authors.lastname: Brix
authors.affiliation: Service de chirurgie maxillofaciale, plastique, reconstructrice et esthétique, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France; Faculté de médecine, université de Lorraine, 54000 Nancy, France.
authors.forename: E
authors.initials: E
authors.lastname: Simon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015992:Body Mass Index; D003646:Debridement / Q000379:methods; D020405:Dermis / Q000473:pathology; D048909:Diabetes Complications / Q000401:mortality; D004927:Escherichia coli Infections / Q000150:complications*; D019115:Fasciitis, Necrotizing / Q000382:microbiology* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Bacterial necrotizing dermis-hypodermitis; Dermo-hypodermites nécrosantes; Fasciites nécrosantes; Necrotizing cellulitis; Necrotizing fasciitis; Quality of life; Qualité de vie; SF 36; Satisfaction