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Approaches to Surgical Debridement in Necrotizing Soft Tissue Infections: Outcomes of an Animated, Interactive Survey
BACKGROUND: Necrotizing soft tissue infections (NSTI) affect long-term quality of life in survivors. Different approaches to debridement may influence quality of life. The aim of this study was to assess the current practice of the debridement of NSTI in the Netherlands. METHODS: An animated, intera...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8971155/ https://www.ncbi.nlm.nih.gov/pubmed/35187588 http://dx.doi.org/10.1007/s00268-022-06470-8 |
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author | Suijker, Jaco Hofmans, Fabienne A. C. van Zuijlen, Paul P. M. Cense, Huib A. Bonjer, H. Jaap Vries, Annebeth Meij-de |
author_facet | Suijker, Jaco Hofmans, Fabienne A. C. van Zuijlen, Paul P. M. Cense, Huib A. Bonjer, H. Jaap Vries, Annebeth Meij-de |
author_sort | Suijker, Jaco |
collection | PubMed |
description | BACKGROUND: Necrotizing soft tissue infections (NSTI) affect long-term quality of life in survivors. Different approaches to debridement may influence quality of life. The aim of this study was to assess the current practice of the debridement of NSTI in the Netherlands. METHODS: An animated, interactive online survey was distributed among general surgeons and plastic surgeons in the Netherlands. Two NSTI-cases were presented, followed by questions regarding the preferred surgical approach. Case one described a woman with a swollen, red leg, with signs of sepsis and without visible necrosis. Case two described an immunocompromised man with septic shock syndrome and extensive necrosis. RESULTS: In total 232 responses were included (143 general surgeons, 89 plastic surgeons). In case one, 32% chose to preserve all skin, while 17% chose to resect all skin above the affected fascia, including normal-looking skin. In case two, all participants resected necrotic skin, and most (88%) also blue discolored skin. While 32% did not resect more than blue discolored and necrotic skin, 35% also resected red-colored skin, and 21% all skin overlying the affected fascia, including normal colored skin. Respondents working in a hospital with a burn center tended to preserve more skin, whereas plastic surgeons chose more often for skin resection compared to general surgeons. CONCLUSIONS: By using a novel approach to a survey, the authors demonstrate the existence of extensive practice variety regarding the approach to debridement of NSTI among Dutch general and plastic surgeons. Consensus is needed, followed by targeted education of surgeons. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00268-022-06470-8. |
format | Online Article Text |
id | pubmed-8971155 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-89711552022-04-07 Approaches to Surgical Debridement in Necrotizing Soft Tissue Infections: Outcomes of an Animated, Interactive Survey Suijker, Jaco Hofmans, Fabienne A. C. van Zuijlen, Paul P. M. Cense, Huib A. Bonjer, H. Jaap Vries, Annebeth Meij-de World J Surg Original Scientific Report BACKGROUND: Necrotizing soft tissue infections (NSTI) affect long-term quality of life in survivors. Different approaches to debridement may influence quality of life. The aim of this study was to assess the current practice of the debridement of NSTI in the Netherlands. METHODS: An animated, interactive online survey was distributed among general surgeons and plastic surgeons in the Netherlands. Two NSTI-cases were presented, followed by questions regarding the preferred surgical approach. Case one described a woman with a swollen, red leg, with signs of sepsis and without visible necrosis. Case two described an immunocompromised man with septic shock syndrome and extensive necrosis. RESULTS: In total 232 responses were included (143 general surgeons, 89 plastic surgeons). In case one, 32% chose to preserve all skin, while 17% chose to resect all skin above the affected fascia, including normal-looking skin. In case two, all participants resected necrotic skin, and most (88%) also blue discolored skin. While 32% did not resect more than blue discolored and necrotic skin, 35% also resected red-colored skin, and 21% all skin overlying the affected fascia, including normal colored skin. Respondents working in a hospital with a burn center tended to preserve more skin, whereas plastic surgeons chose more often for skin resection compared to general surgeons. CONCLUSIONS: By using a novel approach to a survey, the authors demonstrate the existence of extensive practice variety regarding the approach to debridement of NSTI among Dutch general and plastic surgeons. Consensus is needed, followed by targeted education of surgeons. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00268-022-06470-8. Springer International Publishing 2022-02-20 2022 /pmc/articles/PMC8971155/ /pubmed/35187588 http://dx.doi.org/10.1007/s00268-022-06470-8 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Scientific Report Suijker, Jaco Hofmans, Fabienne A. C. van Zuijlen, Paul P. M. Cense, Huib A. Bonjer, H. Jaap Vries, Annebeth Meij-de Approaches to Surgical Debridement in Necrotizing Soft Tissue Infections: Outcomes of an Animated, Interactive Survey |
title | Approaches to Surgical Debridement in Necrotizing Soft Tissue Infections: Outcomes of an Animated, Interactive Survey |
title_full | Approaches to Surgical Debridement in Necrotizing Soft Tissue Infections: Outcomes of an Animated, Interactive Survey |
title_fullStr | Approaches to Surgical Debridement in Necrotizing Soft Tissue Infections: Outcomes of an Animated, Interactive Survey |
title_full_unstemmed | Approaches to Surgical Debridement in Necrotizing Soft Tissue Infections: Outcomes of an Animated, Interactive Survey |
title_short | Approaches to Surgical Debridement in Necrotizing Soft Tissue Infections: Outcomes of an Animated, Interactive Survey |
title_sort | approaches to surgical debridement in necrotizing soft tissue infections: outcomes of an animated, interactive survey |
topic | Original Scientific Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8971155/ https://www.ncbi.nlm.nih.gov/pubmed/35187588 http://dx.doi.org/10.1007/s00268-022-06470-8 |
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