OBJECTIVE. We review our experience and present our approach to treating cr
aniocervical necrotizing fasciitis (CCNF).
STUDY DESIGN., All cases of CCNF treated at Wayne State University/Detroit
Receiving Hospital from January 1989 to April 2000 were reviewed. Patients
were analyzed for source and extent of infection, microbiology, co-morbidit
ies, antimicrobial therapy, hospital days, surgical interventions, complica
tions, and outcomes.
RESULTS: A review of 250 charts identified 10 cases that met the study crit
eria. Five cases (50%) had spread of infection into the thorax, with only I
(10%) fatality. An average of 24 hospital days (7 to 45), 14 ICU days (6 t
o 21), and 3 surgical procedures (I to 6) per patient was required.
CONCLUSION: Aggressive wound care, broad-spectrum antibiotics, and multiple
surgical interventions resulted in a 90% (9/10) overall survival and 80% (
4/5) survival for those with thoracic extension.
SIGNIFICANCE., This is the largest single institution report of CCNF with t
horacic extension identified to date.