Features and treatment of gas-forming synergistic necrotizing cellulitis: a nine-year retrospective study

BACKGROUND As many doctors know little about gas-forming synergistic necrotizing cellulitis, we retrospectively explored it in our study. METHODS: Totally, 30 patients diagnosed with gas-forming synergistic necrotizing cellulitis between November 2006 and September 2015 were included. They were divided into two groups: open drainage group (19 patients) and aggressive debridement group (11 patients). Retrospectively analyzed data comprised demographic characteristics, APACHE II scores, pathogen culture results, bleeding amount during the operation, white blood cell count, length of hospital stay and recovery. RESULTS: The mortality rate was 26% in the open drainage group and 73% in the aggressive debridement group (p=0.023). There was no statistical difference in the APACHE II score before treatment between the open drainageand aggressive debridement groups (16.6 +/- 4.5 vs 18.1 +/- 7.5, p= 0.511). The APACHE II score was significantly higher after treatment in the aggressive debridement group (14.2 +/- 5.8 score vs 20.1 +/- 9.1, p= 0.038). There were no statistical differences in the white blood count cell before and after treatment (13.49 x 109 +/- 5.05x10(9) cells/L vs 17.46x10(9)+/- 6.94x10(9) cells/L, p= 0.082; 10.37x10(9)+/- 3.54x10(9) cells/L vs 15.47x10(9)+/- 7.51x10(9) cells/L, p=0.055; respectively). The bleeding amount during the operation was significantly more in the aggressive debridement group (315 +/- 112 ml vs 105 +/- 45 ml, p<0.001. CONCLUSION: For treating gas-forming synergistic necrotizing cellulitis, performing open drainage as early as possible isthe most important procedure after admission.