Cirugía de conservación y rehabilitación temprana en fascitis necrotizante masiva de miembros inferiores

Rocio A Avanzi; Matias  Pereira D.; Surya Victoria Kohan Fortuna Figueira; Danilo RE Taype Zamboni; Jorge Barla; Carlos F Sancineto; Guido S. Carabelli

doi:10.31053/1853.0605.v79.n1.32430

Autores/as

Rocio A Avanzi Hospital Italiano de Buenos Aires, Buenos Aires, Ciudad autonoma de Buenos Aires, Argentina
Matias Pereira D. Hospital Italiano de Buenos Aires, Buenos Aires, Ciudad autonoma de Buenos Aires, Argentina
Surya Victoria Kohan Fortuna Figueira Hospital Italiano de Buenos Aires
Danilo RE Taype Zamboni Hospital Italiano de Buenos Aires, Buenos Aires, Ciudad autonoma de Buenos Aires, Argentina
Jorge Barla Hospital Italiano de Buenos Aires, Buenos Aires, Ciudad autonoma de Buenos Aires, Argentina
Carlos F Sancineto Hospital Italiano de Buenos Aires, Buenos Aires, Ciudad autonoma de Buenos Aires, Argentina
Guido S. Carabelli Hospital Italiano de Buenos Aires, Buenos Aires, Ciudad autonoma de Buenos Aires, Argentina

DOI:

https://doi.org/10.31053/1853.0605.v79.n1.32430

Palabras clave:

fascitis necrotizante, desbridamiento, colgajo perforante, terapia de presión negativa para heridas, terapia por ejercicio

Resumen

La fascitis necrotizante es una infección potencialmente letal. Es esencial un diagnóstico y tratamiento temprano. Las técnicas de reconstrucción y los protocolos de rehabilitación han sido escasamente descritos. El objetivo de este trabajo es describir los resultados del tratamiento oportuno para la conservación de miembros y la rehabilitación temprana en un caso de fascitis necrotizante masiva de miembros inferiores. Presentamos un caso de fascitis necrotizante en miembros inferiores, tratado quirúrgicamente mediante sistema de aspiración negativa, colgajos musculares e injerto cutáneo. Describimos su protocolo de rehabilitación y los resultados al año de seguimiento.

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Biografía del autor/a

Rocio A Avanzi, Hospital Italiano de Buenos Aires, Buenos Aires, Ciudad autonoma de Buenos Aires, Argentina
Residente de 3er año en Ortopedia y Traumatología-Hospital Italiano de Buenos Aires

Danilo R. E. Taype Zamboni

Médico especialista en Ortopedia y Traumatología-Hospital Durand

Especialista en Trauma - Hospital Italiano de Buenos Aires

+54 9- 11-50550162

danilo.taype@hospitalitaliano.org.ar

Publicaciones:
- Preliminary outcomes of proximal femur megaspacers.
Sancineto CF, Pereira Duarte M, Garcia Mansilla I, Taype Zamboni DRE, Carabelli GS, Barla JD. Arthroplast Today. 2019 Mar 16;5 (2):164-171. doi: 10.1016/j.artd.2018.09.008. eCollection 2019 Jun.
- Prolonged social lockdown during COVID-19 pandemic and hip fracture epidemiology.
Slullitel PA, Lucero CM, Soruco ML, Barla JD, Benchimol JA, Boietti BR, Zanotti G, Comba F, Taype-Zamboni DR, Carabelli GS, Piccaluga F, Sancineto CF, Diehl M, Buttaro MA; HipFEIR [Hip Fracture in the Elderly – Institutional Register] Study Group. Int Orthop. 2020 Oct;44(10):1887-1895. doi: 10.1007/s00264-020-04769-6. Epub 2020 Aug 8.
- Validation of a modified Clavien-Dindo Classification for postoperative complications in orthopedic surgery.Camino Willhuber G, Slullitel P, Taype Zamboni D, Albergo J, Terrasa S, Piuzzi N, Boretto J. Rev Fac Cien Med Univ Nac Cordoba. 2020 Aug 21;77(3):161-167. doi: 10.31053/1853.0605.v77.n3.27931.
- A novel radiological projection of the pelvis to evaluate the sitting imbalance in pelvis nonunions and malunions.
Sancineto CF, Gimenez MV, Taype D, Carabelli G, Barla J. J Clin Orthop Trauma. 2020 Nov-Dec;11(6):1117-1120. doi: 10.1016/j.jcot.2020.10.010. Epub 2020 Oct 9.
- Treatment of Infected Pseudoarthrosis in a Subtrochanteric Fracture in a Patient with Osteopetrosis.
Lionel L, Barla JD, Diego C, Danilo T, Sancineto CF, Carabelli G. Case Rep Orthop. 2020 May 4;2020:5630202. doi: 10.1155/2020/5630202. eCollection 2020.
Matias Pereira D., Hospital Italiano de Buenos Aires, Buenos Aires, Ciudad autonoma de Buenos Aires, Argentina
- Radicular pain due to epidural gas-containing pseudocyst. Report of two cases and review of the literature
  Matias Pereira Duarte, Agustin Maria Garcia Mansilla, Maximiliano Mereles, Julio Bassani, Matias Gustavo Petracchi, Marcelo Gruenberg, Carlos Alberto Sola. IJRRT Journal of International Radiology & Radiation Therapy. August 2018, doi: 10.15406/ijrrt.2018.05.00147
- Percutaneous cement discoplasty for the treatment of advanced degenerative disk disease in elderly patients.
Sola C, Camino Willhuber G, Kido G, Pereira Duarte M, Bendersky M, Mereles M, Petracchi M, Gruenberg M. Eur Spine J. 2018 Mar 23. doi: 10.1007/s00586-018-5547-7
- Preliminary outcomes of proximal femur megaspacers.
Sancineto CF, Pereira Duarte M, Garcia Mansilla I, Taype Zamboni DRE, Carabelli GS, Barla JD. Arthroplast Today. 2019 Mar 16;5 (2):164-171. doi: 10.1016/j.artd.2018.09.008. eCollection 2019 Jun.
- Chylothorax, a rare complication after anterior lumbar interbody fusion. Case report.
Pereira Duarte M, Camino Willhuber G, Estefan M, Kido G, Bassani J, Gruenberg M, Sola C, Petracchi M. Rev Fac Cien Med Univ Nac Cordoba. 2020 Dec 21;77(4):381-384. doi: 10.31053/1853.0605.v77.n4.27982
- Percutaneous Cement Discoplasty for the Treatment of Advanced Degenerative Disc Conditions: A Case Series Analysis.
Camino Willhuber G, Kido G, Pereira Duarte M, Estefan M, Bendersky M, Bassani J, Petracchi M, Gruenberg M, Sola C. Global Spine J. 2020 Sep;10(6):729-734. doi: 10.1177/2192568219873885. Epub 2019 Sep 6.
Danilo RE Taype Zamboni, Hospital Italiano de Buenos Aires, Buenos Aires, Ciudad autonoma de Buenos Aires, Argentina
- Preliminary outcomes of proximal femur megaspacers.
Sancineto CF, Pereira Duarte M, Garcia Mansilla I, Taype Zamboni DRE, Carabelli GS, Barla JD. Arthroplast Today. 2019 Mar 16;5 (2):164-171. doi: 10.1016/j.artd.2018.09.008. eCollection 2019 Jun.
- Prolonged social lockdown during COVID-19 pandemic and hip fracture epidemiology.
Slullitel PA, Lucero CM, Soruco ML, Barla JD, Benchimol JA, Boietti BR, Zanotti G, Comba F, Taype-Zamboni DR, Carabelli GS, Piccaluga F, Sancineto CF, Diehl M, Buttaro MA; HipFEIR [Hip Fracture in the Elderly – Institutional Register] Study Group. Int Orthop. 2020 Oct;44(10):1887-1895. doi: 10.1007/s00264-020-04769-6. Epub 2020 Aug 8.
- Validation of a modified Clavien-Dindo Classification for postoperative complications in orthopedic surgery.Camino Willhuber G, Slullitel P, Taype Zamboni D, Albergo J, Terrasa S, Piuzzi N, Boretto J. Rev Fac Cien Med Univ Nac Cordoba. 2020 Aug 21;77(3):161-167. doi: 10.31053/1853.0605.v77.n3.27931.
- A novel radiological projection of the pelvis to evaluate the sitting imbalance in pelvis nonunions and malunions.
Sancineto CF, Gimenez MV, Taype D, Carabelli G, Barla J. J Clin Orthop Trauma. 2020 Nov-Dec;11(6):1117-1120. doi: 10.1016/j.jcot.2020.10.010. Epub 2020 Oct 9.
- Treatment of Infected Pseudoarthrosis in a Subtrochanteric Fracture in a Patient with Osteopetrosis.
Lionel L, Barla JD, Diego C, Danilo T, Sancineto CF, Carabelli G. Case Rep Orthop. 2020 May 4;2020:5630202. doi: 10.1155/2020/5630202. eCollection 2020.
Jorge Barla, Hospital Italiano de Buenos Aires, Buenos Aires, Ciudad autonoma de Buenos Aires, Argentina
- Survival and functionality in the elderly over 85 years of age with hip fracture.
Benchimol JA, Elizondo CM, Giunta DH, Schapira MC, Pollan JA, Barla JD, Carabelli GS, Boietti BR. Rev Esp Cir Ortop Traumatol. 2020 Jul-Aug;64(4):265-271. doi: 10.1016/j.recot.2020.02.001. Epub 2020 Apr 1.
- Prolonged social lockdown during COVID-19 pandemic and hip fracture epidemiology.
Slullitel PA, Lucero CM, Soruco ML, Barla JD, Benchimol JA, Boietti BR, Zanotti G, Comba F, Taype-Zamboni DR, Carabelli GS, Piccaluga F, Sancineto CF, Diehl M, Buttaro MA; HipFEIR [Hip Fracture in the Elderly – Institutional Register] Study Group. Int Orthop. 2020 Oct;44(10):1887-1895. doi: 10.1007/s00264-020-04769-6. Epub 2020 Aug 8.
- A novel radiological projection of the pelvis to evaluate the sitting imbalance in pelvis nonunions and malunions.
Sancineto CF, Gimenez MV, Taype D, Carabelli G, Barla J. J Clin Orthop Trauma. 2020 Nov-Dec;11(6):1117-1120. doi: 10.1016/j.jcot.2020.10.010. Epub 2020 Oct 9.
- Treatment of Infected Pseudoarthrosis in a Subtrochanteric Fracture in a Patient with Osteopetrosis.
Lionel L, Barla JD, Diego C, Danilo T, Sancineto CF, Carabelli G. Case Rep Orthop. 2020 May 4;2020:5630202. doi: 10.1155/2020/5630202. eCollection 2020.
- The AO trauma CPP bone infection registry: Epidemiology and outcomes of Staphylococcus aureus bone infection.
Morgenstern M, Erichsen C, Militz M, Xie Z, Peng J, Stannard J, Metsemakers WJ, Schaefer D, Alt V, Søballe K, Nerlich M, Buckley RE, Blauth M, Suk M, Leung F, Barla JD, Yukata K, Qing B, Kates SL.

J Orthop Res. 2021 Jan;39(1):136-146. doi: 10.1002/jor.24804. Epub 2020 Jul 27.
Carlos F Sancineto, Hospital Italiano de Buenos Aires, Buenos Aires, Ciudad autonoma de Buenos Aires, Argentina
- Preliminary outcomes of proximal femur megaspacers.
Sancineto CF, Pereira Duarte M, Garcia Mansilla I, Taype Zamboni DRE, Carabelli GS, Barla JD.

Arthroplast Today. 2019 Mar 16;5(2):164-171. doi: 10.1016/j.artd.2018.09.008. eCollection 2019 Jun.
- Preliminary outcomes of proximal femur megaspacers.
Sancineto CF, Pereira Duarte M, Garcia Mansilla I, Taype Zamboni DRE, Carabelli GS, Barla JD. Arthroplast Today. 2019 Mar 16;5 (2):164-171. doi: 10.1016/j.artd.2018.09.008. eCollection 2019 Jun.
- Prolonged social lockdown during COVID-19 pandemic and hip fracture epidemiology.
Slullitel PA, Lucero CM, Soruco ML, Barla JD, Benchimol JA, Boietti BR, Zanotti G, Comba F, Taype-Zamboni DR, Carabelli GS, Piccaluga F, Sancineto CF, Diehl M, Buttaro MA; HipFEIR [Hip Fracture in the Elderly – Institutional Register] Study Group. Int Orthop. 2020 Oct;44(10):1887-1895. doi: 10.1007/s00264-020-04769-6. Epub 2020 Aug 8.
- A novel radiological projection of the pelvis to evaluate the sitting imbalance in pelvis nonunions and malunions.
Sancineto CF, Gimenez MV, Taype D, Carabelli G, Barla J. J Clin Orthop Trauma. 2020 Nov-Dec;11(6):1117-1120. doi: 10.1016/j.jcot.2020.10.010. Epub 2020 Oct 9.
- Treatment of Infected Pseudoarthrosis in a Subtrochanteric Fracture in a Patient with Osteopetrosis.
Lionel L, Barla JD, Diego C, Danilo T, Sancineto CF, Carabelli G. Case Rep Orthop. 2020 May 4;2020:5630202. doi: 10.1155/2020/5630202. eCollection 2020.
Guido S. Carabelli, Hospital Italiano de Buenos Aires, Buenos Aires, Ciudad autonoma de Buenos Aires, Argentina
- Preliminary outcomes of proximal femur megaspacers.
Sancineto CF, Pereira Duarte M, Garcia Mansilla I, Taype Zamboni DRE, Carabelli GS, Barla JD.

Arthroplast Today. 2019 Mar 16;5(2):164-171. doi: 10.1016/j.artd.2018.09.008. eCollection 2019 Jun.
- Survival and functionality in the elderly over 85 years of age with hip fracture.
Benchimol JA, Elizondo CM, Giunta DH, Schapira MC, Pollan JA, Barla JD, Carabelli GS, Boietti BR. Rev Esp Cir Ortop Traumatol. 2020 Jul-Aug;64(4):265-271. doi: 10.1016/j.recot.2020.02.001. Epub 2020 Apr 1.
- Prolonged social lockdown during COVID-19 pandemic and hip fracture epidemiology.
Slullitel PA, Lucero CM, Soruco ML, Barla JD, Benchimol JA, Boietti BR, Zanotti G, Comba F, Taype-Zamboni DR, Carabelli GS, Piccaluga F, Sancineto CF, Diehl M, Buttaro MA; HipFEIR [Hip Fracture in the Elderly – Institutional Register] Study Group. Int Orthop. 2020 Oct;44(10):1887-1895. doi: 10.1007/s00264-020-04769-6. Epub 2020 Aug 8.
- A novel radiological projection of the pelvis to evaluate the sitting imbalance in pelvis nonunions and malunions.
Sancineto CF, Gimenez MV, Taype D, Carabelli G, Barla J. J Clin Orthop Trauma. 2020 Nov-Dec;11(6):1117-1120. doi: 10.1016/j.jcot.2020.10.010. Epub 2020 Oct 9.
- Treatment of Infected Pseudoarthrosis in a Subtrochanteric Fracture in a Patient with Osteopetrosis.
Lionel L, Barla JD, Diego C, Danilo T, Sancineto CF, Carabelli G. Case Rep Orthop. 2020 May 4;2020:5630202. doi: 10.1155/2020/5630202. eCollection 2020.

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