Subscribe to RSS
Download PDF
DOI: 10.1055/s-0043-1773770
Wound Coverage in Extensive Necrotizing Fasciitis with Chronic Liver Disease
Abstract
Chronic liver disease is characterized by lowered immunity, altered hematological parameters, and poor wound healing. Surgeons may hesitate to intervene in such patients when they present with necrotizing fasciitis (NF) or misinform the patients regarding their chances of survival. This is because of the poor nutritional state, thrombocytopaenia, and abnormal coagulation profile. However, recent guidelines show that platelet count and prothrombin time/international normalized ratio (PT-INR) do not predict postoperative bleeding. We can proceed with debridement followed by skin grafting of wounds in such patients. This will help reduce the high mortality rate of NF in cirrhotic patients.
Publication History
Article published online:
26 September 2023
© 2023. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
-
References
- 1 Silva M, Gomes S, Peixoto A. et al. Nutrition in chronic liver disease. GE Port J Gastroenterol 2015; 22 (06) 268-276
- 2 Wilde B, Katsounas A. Immune dysfunction and albumin-related immunity in liver cirrhosis. Mediators Inflamm 2019; 2019: 7537649
- 3 O'Shea RS, Davitkov P, Ko CW. et al. AGA clinical practice guideline on the management of coagulation disorders in patients with cirrhosis. Gastroenterology 2021; 161 (05) 1615-1627.e1
- 4 European Association for the Study of the Liver. Electronic address: easloffice@easloffice.eu, European Association for the Study of the Liver. EASL Clinical Practice Guidelines on prevention and management of bleeding and thrombosis in patients with cirrhosis. J Hepatol 2022; 76 (05) 1151-1184
- 5 Agarwal P, Prajapati B, Sharma D. Evaluation of skin graft take following post-burn raw area in normovolaemic anaemia. Indian J Plast Surg 2009; 42 (02) 195-198
- 6 Kale AR, Sonawane CS, Wagh AA, Mangukiya HJ, Waghmare VU. A retrospective study of effect of anaemia on split thickness skin graft uptake in orthopaedic trauma cases. International Journal of Orthopaedics Sciences 2017; 3 (04) 562-564