ABSTRACT
The clinical presentations of deep soft tissue infections can, initially, mimicry superficial skin infections such as erysipelas. However, a rapidly deteriorating health status, the spreading of the lesions and the lack of clear visual limitation of the infection on the skin are hallmarks of a more severe underlying infection, which may endanger patients' life. An immediate adequate multidisciplinary approach to therapy within a few hours is mandatory. The first step is surgical exploration with debridement of all infected tissues, accompanied by antibiotic therapy and additional supportive measures. Despite progress in the understanding of the physiopathology, the delay between suspicion of diagnosis and surgical exploration remains critical. Because of the low incidence of such severe infections, only multicenter studies might reveal deeper insights of optimal therapeutic strategies in the future and for possible improved patients' survival.
Subject(s)
Soft Tissue Infections/therapy , Anti-Bacterial Agents/therapeutic use , Debridement , Humans , Hyperbaric Oxygenation , Soft Tissue Infections/diagnosis , Soft Tissue Infections/microbiologySubject(s)
Aortic Rupture/complications , Colon/blood supply , Ischemia/etiology , Aorta, Thoracic/injuries , Humans , Male , Middle AgedABSTRACT
The analgesic action of fentanyl administered by epidural injection in a dose of 0.2 mg diluted in 10 ml of physiological saline proved to be satisfactory in 21 patients who had undergone abdominal surgery. The mean duration of analgesia was 6 hours. The subjective improvement was associated with an increase in V.C. (congruent to 30%) and good tolerance of postoperative chest physiotherapy. Despite the absence of respiratory depression, the existence of drowsiness is suggestive of central impregnation the degree and role of which remain to be defined.
