Septic acute Tenosynovitis of the Flexor Hallucis Longus Tendon Complicating a Lower Limb Erysipelas

Erysipelas is the most common bacterial dermal-hypodermal acute not necrotizing infection [1,2]. Its evolution is usually mild but can be complicated mainly by local abscess or necrosis [3-7]. In this context osteo-articular complications and septic acute tenosynovitis are rarely described in the literature with a rate of 1.2% [3]. We report in the light of a literature review a case of recurrent erysipelas of the leg in a young patient of 29 years complicated by septic acute tenosynovitis of the flexor hallucis longus (FHL), to remind this complication mainly observed in severe forms of erysipelas which is not the case of our patient.

638 Biodegradable Temporizing Matrix in Combination with Wide Meshed Graft and Autologous Spray Cell Suspension (ASCS) Graft Can be Used for Reconstruction of Extensive Necrotizing Infections: A Case Report

Introduction Background: A necrotizing infection of the left upper extremity underwent extensive debridement with remaining exposed muscle, tendon, and bone. BTM was used to provide an acceptable temporizing matrix in conjunction with wide meshed split thickness skin graft (STSG) 3:1 ratio and ASCS graft for successful reconstruction. This left a functional limb and avoided arm forequarter amputation. Methods Case Presentation: We present a 67 y/o male with necrotizing infection who underwent extensive surgical debridement of skin and subcutaneous tissues of the left hand, forearm, and upper arm. BTM was applied for coverage over muscle, tendon, and bone to salvage his arm and avoid forequarter amputation. Following maturation of the BTM a 3:1 ratio STSG was placed along with application of an ASCS graft. A vacuum assisted closure (VAC) dressing was successfully used to stabilize the grafts. One month post grafting the wound was approximately 94% healed, with good range of motion, and limited but improving function of his arm. Results Conclusion: Necrotizing infection extremity reconstruction can be achieved with BTM, wide meshed STSG, and autologous ASCS grafting. A wound VAC provided a safe and effective dressing over these grafted mediums. Conclusions Conclusion: Necrotizing infection extremity reconstruction can be achieved with BTM, wide meshed STSG, and ASCS epidermal autograft. A wound VAC provided a safe and effective dressing over these grafted mediums.

A RARE CASE OF EMPHYSEMATOUS PANCREATITIS: A CASE REPORT

High mortality is noted with a rare complication of pancreatitis also known as emphysematous pancreatitis. Here we present a rare case of a 40 years old male patient presented with complain of epigastric pain. It is considered as a surgical emergency. Keywords: mortality, surgery, emphysematous pancreatitis, necrotizing infection

SURGICAL TREATMENT OF NECROTIZING INFECTION OF THE SOFT TISSUES OF THE NECK

Summary. Early diagnosis and timely surgical treatment of necrotizing soft tissue infection of the neck is an urgent problem of modern medicine, far from a definitive solution. The purpose of the work is to optimize the surgical treatment of patients with necrotizing infection of the soft tissues of the neck. Materials and methods. The results of surgical interventions of 76 patients with odontogenic phlegmon of the neck that were treated at the surgical ward were analyzed. Results and discussion. The essential condition for successful treatment of phlegmon neck is immediate surgery. Indications for surgery in the mediastinum should be considered in the total involvement in the necrotic process of the deep and superficial cell spaces of the neck. Preventive antibiotic therapy in patients after surgery on the neck helps to reduce the incidence of postoperative inflammatory complications and improve the quality of life of patients. Conclusions. Mortality in acute purulent odontogenic mediastinitis depends on timely hospitalization, diagnosis and early surgical treatment using extracorporeal detoxification methods.