Postoperative necrotizing soft-tissue infections of the abdominal wall

Objective: The aim of the underlying study was the evaluation of an aggress ive surgical regimen for treatment of postoperative necrotizing soft-tissue infection (NSTI). Methods: Eight patients with postoperative NSTI of the a bdominal wall after emergency (n=6) and elective (n=2) surgery were reviewe d over a 9-year period. Results: Initially, three patients presented with g eneral peritonitis. Cultured swabs from the necrotic tissue revealed three to four different types of bacteria in each patient. The mean interval betw een the primary operation and clinical symptoms of NSTI was 63.0 h. Control of NSTI and intra-abdominal infection was attained by scheduled re-operati ons on a daily basis accounting for three to six re-interventions in each p atient. Temporary closure of the abdominal wall by absorbable polyglactid-a cid mesh was used in six cases. Mean hospital stay was 65.3 days (18-110 da ys). Two of the eight patients died from cardiac arrest and multiple organ failure, respectively. Conclusions: Rapid diagnosis and onset of treatment is accomplished by the surgeons' knowledge of this disease and a close foll ow-up of the patients in an intensive care unit.