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Management and Novel Adjuncts of Necrotizing Soft Tissue Infections.

Abstract Necrotizing soft tissue infections (NSTI) have been recognized for millennia and continue to impose considerable burden on both patient and society in terms of morbidity, death, and the allocation of resources. With improvements in the delivery of critical care, outcomes have improved, although disease-specific therapies are lacking. The basic principles of early diagnosis, of prompt and broad antimicrobial therapy, and of aggressive debridement have remained unchanged. Clearly novel and new therapeutics are needed to combat this persistently lethal disease. This review emphasizes the pillars of NSTI management and then summarizes the contemporary evidence supporting the incorporation of novel adjuncts to the pharmacologic and operative foundations of managing this disease.
PMID
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Authors

Mayor MeshTerms

Debridement

Keywords

necrotizing fasciitis

necrotizing soft tissue infection

sepsis

Journal Title surgical infections
Publication Year Start




PMID- 28375805
OWN - NLM
STAT- MEDLINE
DA  - 20170404
DCOM- 20170417
LR  - 20170417
IS  - 1557-8674 (Electronic)
IS  - 1096-2964 (Linking)
VI  - 18
IP  - 3
DP  - 2017 Apr
TI  - Management and Novel Adjuncts of Necrotizing Soft Tissue Infections.
PG  - 250-272
LID - 10.1089/sur.2016.200 [doi]
AB  - Necrotizing soft tissue infections (NSTI) have been recognized for millennia and 
      continue to impose considerable burden on both patient and society in terms of
      morbidity, death, and the allocation of resources. With improvements in the
      delivery of critical care, outcomes have improved, although disease-specific
      therapies are lacking. The basic principles of early diagnosis, of prompt and
      broad antimicrobial therapy, and of aggressive debridement have remained
      unchanged. Clearly novel and new therapeutics are needed to combat this
      persistently lethal disease. This review emphasizes the pillars of NSTI
      management and then summarizes the contemporary evidence supporting the
      incorporation of novel adjuncts to the pharmacologic and operative foundations of
      managing this disease.
FAU - Cocanour, Christine S
AU  - Cocanour CS
AD  - Department of Surgery, University of Pittsburgh , Pittsburgh, Pennsylvania.
FAU - Chang, Phillip
AU  - Chang P
AD  - Department of Surgery, University of Pittsburgh , Pittsburgh, Pennsylvania.
FAU - Huston, Jared M
AU  - Huston JM
AD  - Department of Surgery, University of Pittsburgh , Pittsburgh, Pennsylvania.
FAU - Adams, Charles A Jr
AU  - Adams CA Jr
AD  - Department of Surgery, University of Pittsburgh , Pittsburgh, Pennsylvania.
FAU - Diaz, Jose J
AU  - Diaz JJ
AD  - Department of Surgery, University of Pittsburgh , Pittsburgh, Pennsylvania.
FAU - Wessel, Charles B
AU  - Wessel CB
AD  - Department of Surgery, University of Pittsburgh , Pittsburgh, Pennsylvania.
FAU - Falcione, Bonnie A
AU  - Falcione BA
AD  - Department of Surgery, University of Pittsburgh , Pittsburgh, Pennsylvania.
FAU - Bauza, Graciela M
AU  - Bauza GM
AD  - Department of Surgery, University of Pittsburgh , Pittsburgh, Pennsylvania.
FAU - Forsythe, Raquel A
AU  - Forsythe RA
AD  - Department of Surgery, University of Pittsburgh , Pittsburgh, Pennsylvania.
FAU - Rosengart, Matthew R
AU  - Rosengart MR
AD  - Department of Surgery, University of Pittsburgh , Pittsburgh, Pennsylvania.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20170404
PL  - United States
TA  - Surg Infect (Larchmt)
JT  - Surgical infections
JID - 9815642
RN  - 0 (Anti-Infective Agents)
SB  - IM
MH  - Anti-Infective Agents/*therapeutic use
MH  - Combined Modality Therapy
MH  - *Debridement
MH  - Fasciitis, Necrotizing/*epidemiology/*therapy
MH  - Humans
OTO - NOTNLM
OT  - *necrotizing fasciitis
OT  - *necrotizing soft tissue infection
OT  - *sepsis
EDAT- 2017/04/05 06:00
MHDA- 2017/04/18 06:00
CRDT- 2017/04/05 06:00
AID - 10.1089/sur.2016.200 [doi]
PST - ppublish
SO  - Surg Infect (Larchmt). 2017 Apr;18(3):250-272. doi: 10.1089/sur.2016.200. Epub
      2017 Apr 4.

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