Case Report
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World J Gastroenterol. Jun 28, 2014; 20(24): 7988-7992
Published online Jun 28, 2014. doi: 10.3748/wjg.v20.i24.7988
Necrotizing fasciitis secondary to enterocutaneous fistula: Three case reports
Guo-Li Gu, Lin Wang, Xue-Ming Wei, Ming Li, Jie Zhang
Guo-Li Gu, Xue-Ming Wei, Department of General Surgery, Air Force General Hospital, Chinese PLA, Beijing 100142, China
Lin Wang, Ming Li, Jie Zhang, Department of Colorectal Surgery, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing 100142, China
Author contributions: Gu GL and Zhang J contributed equally to this work; Gu GL, Wei XM and Zhang J designed the research; Gu GL, Zhang J, Li M and Wei XM performed the research and wrote the paper; Gu GL and Wang L revised the manuscript.
Supported by General Projects of the Chinese PLA “Twelfth Five-Year” Logistics Research Subject, No. CKJ11J020
Correspondence to: Jie Zhang, Professor, Department of Colorectal Surgery, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Fucheng Road 52, Haidian Str, Beijing 100142, China. hero1822@163.com
Telephone: +86-10-88196085 Fax: +86-10-88196085
Received: March 13, 2014
Revised: April 15, 2014
Accepted: April 28, 2014
Published online: June 28, 2014
Processing time: 106 Days and 10.3 Hours
Abstract

Necrotizing fasciitis (NF) is an uncommon, rapidly progressive, and potentially fatal infection of the superficial fascia and subcutaneous tissue. NF caused by an enterocutaneous fistula has special clinical characters compared with other types of NF. NF caused by enterocutaneous fistula may have more rapid progress and more severe consequences because of multiple germs infection and corrosion by digestive juices. We treated three cases of NF caused by postoperative enterocutaneous fistula since Jan 2007. We followed empirically the principle of eliminating anaerobic conditions of infection, bypassing or draining digestive juice from the fistula and changing dressings with moist exposed burn therapy impregnated with zinc/silver acetate. These three cases were eventually cured by debridement, antibiotics and wound management.

Keywords: Necrotizing fasciitis; Enterocutaneous fistula; Diagnosis; Treatment

Core tip: Necrotizing fasciitis (NF) caused by enterocutaneous fistula may have more rapid progress and more severe consequences because of multiple bacterial infection and corrosion by digestive juices. Treating with three cases of NF secondary to enterocutaneous fistula, indicated that it was vital to heal NF by eliminating anaerobic conditions of infection, bypassing or draining digestive juice from fistula, and changing dressings with moist burn medical technology.