Necrotizing fasciitis - a rare complication following common obstetric operative procedures: report of two cases

Necrotizing fasciitis, a near-fatal soft-tissue infection complicating obstetric operative wounds, is a rare entity in obstetrics. Herein, we report two cases of necrotizing fasciitis in severely undernourished and anemic women following obstetric operative procedures. Both undernourishment and anem...

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Bibliographic Details
Published inInternational journal of women's health Vol. 7; no. default; pp. 357 - 360
Main Authors Medhi, Robin, Rai, Suditi, Das, Arpana, Ahmed, Mansur, Das, Banani
Format Journal Article
LanguageEnglish
Published New Zealand Dove Medical Press Limited 01.01.2015
Taylor & Francis Ltd
Dove Medical Press
Subjects
Anemia
Antibiotics
Blood pressure
Blood transfusions
Body mass index
Care and treatment
Case Report
Case reports
Case studies
Cesarean section
Diagnosis
Health aspects
Hemoglobin
Intensive care
Laboratories
Malnutrition
Medical prognosis
Mortality
Necrotizing fasciitis
Nutrition
Obstetrics
Pain
Parenteral nutrition
Patients
Postpartum period
Potassium
Proteins
Risk factors
Skin
Ulcers
Womens health
India
total parenteral nutrition
undernourishment
anemia
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Summary:Necrotizing fasciitis, a near-fatal soft-tissue infection complicating obstetric operative wounds, is a rare entity in obstetrics. Herein, we report two cases of necrotizing fasciitis in severely undernourished and anemic women following obstetric operative procedures. Both undernourishment and anemia compounded the already existing immune-suppressed state in pregnancy and may have lead to life-threatening necrotizing fasciitis. One of the patients developed necrotizing fasciitis following episiotomy and the other following cesarean section. Both the cases were diagnosed clinically. Management was done by total parenteral nutrition, prompt correction of anemia, and surgical debridement under broad-spectrum antibiotic coverage. The raw areas were later reconstructed by split skin grafting in the first case, whereas, in the second case, due to the patient's refusal of skin grafting, the wound was allowed to heal by secondary intention. Both patients survived, although with morbidity. Our study aims to emphasize prompt correction of comorbidities along with aggressive management of necrotizing fasciitis for better outcomes in the obstetric population. Prompt correction of nutritional status improves the survival rate.
ISSN:1179-1411
1179-1411
DOI:10.2147/IJWH.S76516