Page 288 - Read Online
P. 288

grafting. Negative pressure wound therapy was used in   Conflicts of interest
            patients with necrotizing soft tissue infection to evacuate   There are no conflicts of interest.
            wound secretions and blood, thereby shortening the
                                                [11]
            duration for split thickness skin grafting.  In all the   REFERENCES
            patients hyperbaric oxygen therapy was initiated as
            earlier as possible. Hyperbaric oxygen was delivered by   1.   Hodgins N, Damkat-Thomas L, Shamsian N, Yew P, Lewis H, Khan K.
            means of monoplace chamber with pressure ranging      Analysis of the increasing prevalence of necrotising fasciitis referrals
            from 1.8 to 2.4 ATA for 90 min in duration. Reduction   to a regional plastic surgery unit: a retrospective case series. J Plast
                                                                  Reconstr Aesthet Surg 2015;68:304-11.
            of edema due to hyperbaric oxygen therapy helps in   2.   Morpurgo E, Galandiuk S. Fournier’s gangrene. Surg Clin North Am
            increased uptake of the skin graft and prevents venous   2002;82:1213-24.
            congestion in the transferred flaps. Hyperoxia may also   3.   Pastore AL, Palleschi G, Ripoli A, Silvestri L, Leto A, Autieri D,
                                                                  Maggioni C, Moschese D, Petrozza V, Carbone A. A multistep approach
            enhance intracellular transport of antibiotics. We did   to manage Fournier’s gangrene in a patient with unknown type II
            not experience the toxicity related to hyperbaric oxygen   diabetes: surgery, hyperbaric oxygen, and vacuum-assisted closure
            therapy. Hyperbaric oxygen therapy is used as an adjunct   therapy: a case report. J Med Case Rep 2013;7:1.
            to prevent propagation of infection following wound   4.   Korhonen K, Kuttila K, Niinikoski J. Tissue gas tensions in patients
                                                                  with necrotising fasciitis and healthy controls during treatment with
            debridement. The length of hospital stay of necrotizing   hyperbaric oxygen: a clinical study. Eur J Surg 2000;166:530-4.
            infection could be significantly reduced if there is   5.   Flam F, Boijsen M, Lind F. Necrotizing fasciitis following transobturator
            early detection of inflammation, early application oh   tape  treated  by  extensive  surgery  and  hyperbaric  oxygen. Int
                                                                  Urogynecol J Pelvic Floor Dysfunct 2009;20:113-5.
                                                       [12]
            hyperbaric therapy and early surgical intervention.  In   6.   Chen SY, Fu JP, Wang CH, Lee TP, Chen SG. Fournier gangrene: a
            our institution, an algorithm [Figure 4] was developed   review of 41 patients and strategies for reconstruction. Ann Plast Surg
            for incorporating hyperbaric oxygen therapy into the   7.   2010;64:765-9.
                                                                  Oufkir AA, Tazi MF, El Alami MN. The superomedial thigh flap in
            treatment protocol.                                   scrotal reconstruction: technical steps to improve cosmetic results.
                                                                  Indian J Urol 2013;29:360-2.
            In conclusion, management of soft tissue loss of peno-  8.   Katusabe LJ, Balumuka D, Hodges A. Scrotal reconstruction with a
            scrotal region requires an organized approach and the   pedicled gracilis muscle flap after debridement of fournier’s gangrene:
                                                                  a case report. East Afr Med J 2013;90:375-8.
            utilization of newer modalities for quick recovery of   9.   El-Mageed MA. Evaluation of the anteromedial thigh fasciocutaneous
            these injuries is of foremost need. Operating surgeons   flap for scrotal reconstruction. J Plast Reconstr Surg 2007;31:149-55.
            should know the various reconstructive pathways and   10.  Konofaos P, Hickerson WL. A technique for improving cosmesis
            use of adjunct measures like hyperbaric therapy for   after primary scrotum reconstruction with skin grafts. Ann Plast Surg
                                                                  2015;75:205-7.
            prompt recovery.                                  11.  Agostini T, Mori F, Perello R, Dini M, Russo GL. Successful combined
                                                                  approach to a severe Fournier’s gangrene.  Indian J Plast Surg
                                                                  2014;47:132-6.
            Financial support and sponsorship                 12.  Mallikarjuna MN, Vijayakumar A, Patil VS, Shivswamy BS. Fournier’s
            Nil.                                                  gangrene: current practices. ISRN Surg 2012;2012:942437..



































            278                                                              Plast Aesthet Res || Volume 3 || August 12, 2016
   283   284   285   286   287   288   289   290   291   292   293