Necrotizing fasciitis after total abdominal hysterectomy: A case report.

RATIONALE: Necrotizing fasciitis is rapidly progressive infection with high mortality rate. This study aimed to summarize the clinical and pathological presentation of this case. PATIENT CONCERNS: A 46-year-old woman patient presented to our emergency department of an obstetric and gynecology clinic on the 8th day after total abdominal hysterectomy. The abdominal wall showed pronounced signs of inflammation. Abundant purulent content was oozing from the abdominal wound. DIAGNOSES: The patient underwent surgery. Areas of necrosis were observed on the skin around the wound, the subcutaneous fatty tissue was necrotic around the incision site, and the fascia was completely dehisced. INTERVENTIONS: Wound debridement and flap cutting of the anterior abdominal wall were performed. Metronidazole, ceftriaxone, and vancomycin were administered intravenously. A plastic surgeon suggested daily debridement and toileting of the wound in the operating room. Swabs of the abdominal cavity, abscess cavity, and abdominal wound were obtained, and Enterococcus faecalis was isolated. After the negativism of microbiological swabs, excochleation of granulation tissue was performed by a plastic surgeon. OUTCOMES: Nineteen days after the relaparotomy, the patient was discharged in good general condition with advice for further monitoring and therapy. LESSONS: Successful treatment of necrotizing fasciitis can be achieved through an initial diagnosis, adequate debridement, empirical broad-spectrum antibiotic coverage, and multidisciplinary treatment.

Knowledge About Head and Neck Cancer in the Population of Vojvodina: A Comparative Study.

In 2009, the Institute of Oncology of Vojvodina reported the total of 553 newly registered patients with head and neck cancer (HNC) in the Province of Vojvodina, with a lethal outcome in 332 HNC patients. These facts impose the need of investigating the health education of the general population and proposing possible prevention measures. The present prospective study included 200 subjects classified into two groups. Group 1 (100 subjects) consisted of randomly selected adults from urban and rural regions of Vojvodina. Group II (100 subjects) included the adults from the same regions affected by HNC. All subjects answered the anonymous questionnaire which complied with the standards of a similar European Union research project "About Face". The results showed that 96% of the subjects from the Group II and only 77% of the subjects from the Group I were familiar with the term "head and neck cancer" what represented a significant difference. The results from Vojvodina were significantly better than those from the European study (23%). Most subjects were informed about HNC through television programs (60%), hospital leaflets (41%) or internet (37%). Both the patients and the citizens of Vojvodina were better informed about the most common localizations of HNC-pharynx and larynx, but less informed about other HNC localizations than the citizens of seven European countries. The citizens and the HNC patients from Vojvodina were equally well informed about some risk factors (e.g., smoking, alcoholism, aging and sun exposure) as the citizens in Europe. Both the patients and the general population of Vojvodina are mostly worried about the consequences/side effects of the applied surgical treatment. The obtained results may be a good starting point in the prevention and early detection of HNC in Vojvodina.