Early recognition of potentially fatal necrotizing fasciitis. The use of frozen-section biopsy.

Details

Serval ID
serval:BIB_1B55CE82A0F5
Type
Article: article from journal or magazin.
Collection
Publications
Title
Early recognition of potentially fatal necrotizing fasciitis. The use of frozen-section biopsy.
Journal
New England Journal of Medicine
Author(s)
Stamenkovic I., Lew P.D.
ISSN
0028-4793[print], 0028-4793[linking]
Publication state
Published
Issued date
1984
Volume
310
Number
26
Pages
1689-1693
Language
english
Notes
Publication types: Journal Article
Abstract
Necrotizing fasciitis is a rare, rapidly progressing soft-tissue infection. Early clinical recognition is difficult, and there is often a fatal delay in appropriate treatment. We evaluated the use of frozen-section biopsies for the rapid diagnosis of this disease in its early stages. Nineteen cases of necrotizing fasciitis were studied over a 13-year period. In all eight cases in which frozen-section biopsy was performed within zero to four days (average, 21 hours) after the onset of symptoms, histologic study confirmed the diagnosis, and surgical d ebridement was immediately performed. Only one patient died. In 11 patients, the diagnosis was made on clinical grounds, and surgical therapy was delayed for 1 to 15 days (average, 6) after the onset of symptoms because of failure to recognize the disorder immediately. Eight patients died (P less than 0.02). Our study indicates that rapid performance of frozen-section soft-tissue biopsy early in the evolution of a suspect lesion may provide a definitive and life-saving diagnosis.
Keywords
Adult, Aged, Biopsy/methods, Debridement, Fascia/ultrastructure, Fasciitis/diagnosis, Fasciitis/pathology, Female, Frozen Sections, Humans, Male, Middle Aged, Necrosis, Prognosis, Time Factors
Pubmed
Create date
25/08/2010 15:52
Last modification date
03/03/2018 14:30
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