This paper is only available as a PDF. To read, Please Download here.
Abstract
The clinical course and management of 21 children (12 females, 9 males; mean age 2.4 years) with skin necrosis secondary to meningococcal septicaemia is described.
Skin necrosis was most commonly sited in the lower limbs (20 patients). Sixteen patients had multiple areas of involvement and amputation of the digits was required in 5 patients. One required an above knee amputation. Small areas of skin necrosis were managed conservatively (4 patients) but larger areas required debridement and grafting. Skin grafting was delayed in 15 patients and graft loss occurred in 8. Multiple grafting procedures were required in 6 patients. Scar revision was required in 6 patients. Nutritional support is also an important component of management.
References
- Skin loss in meningococcal septicaemia.British Journal of Plastic Surgery. 1980; 33: 251
- Infectious diseases.in: Nelson WE Nelson Textbook of Pediatrics. 15th edition. WB Saunders Co, Philadelphia1987: 589
- Boswick JA The Art and Science of Burn Care. Aspen Publishers Inc, Rockville1987: 104
- Gangrene requiring amputation in meningococcal infection.Irish Medical Journal. 1985; 78: 14
- Role of meningococcal endotoxin in meningococcal purpura.Journal of Experimental Medicine. 1974; 140: 158
- Some recollections of the meningococcal disease.in: The first Harry F. Dowling Lecture. Journal of the American Medical Association. 220. 1972: 1107
- Skin necrosis secondary to meningococcal septicaemia in an adult.Australian and New Zealand Journal of Surgery. 1987; 57: 57
- Skin loss in meningococcal septicaemia: a report of 3 cases.British Journal of Plastic Surgery. 1976; 29: 257
- Meningococcal infections.in: Rudolf AM Pediatrics. 18th edition. Appleton and Lange, Norwalk1987: 516
- Amputation following meningococcemia.Clinical Orthopaedics and Related Research. 1984; 185: 214
- Evolution of quantitative bacteriology in wound management.American Journal of Surgery. 1975; 130: 579
- Amputation for gangrene of the limbs following severe meningococcal infection.Journal of the Royal College of Surgeons of Edinburgh. 1991; 36: 11
- Monthly Vital Statistics Report. Volume 25. HRA 76-1120 Health Resources Administration, Rockville1976 (Number 3 (Suppl))
- Surgical complications of fulminating meningococcaemia.British Journal of Clinical Practice. 1990; 44: 36
- Surgical management of life-threatening and disfiguring sequelae of fulminant meningococcaemia.American Journal of Surgery. 1986; 151: 553
- The management of dermal necrosis after acute neisseria infection.Military Medicine. 1989; 154: 598
- Skin manifestations of meningococcal infection. An immediate indicator of prognosis.American Journal of Diseases of Children. 1974; 127: 173
- Sex differences in susceptibility to infections.Journal of Pediatrics. 1965; 35: 57
- Meningococcal antigen in diagnosis and treatment of Group A meningococcal infections.American Journal of Medicine. 1975; 58: 823
Article info
Publication history
Accepted:
September 21,
1992
Received:
June 17,
1992
Identification
Copyright
© 1993 The British Association of Plastic Surgeons. Published by Elsevier Inc.
