Abstract

MARTINEZ-SANCHEZ, David Josué; WALDO-HERNANDEZ, Luis Iván; PALOMARES-CAPETILLO, Paola  and  VAZQUEZ-MINERO, Juan Carlos. Airway management in a patient with necrotizing cervical fascitis. Neumol. cir. torax [online]. 2023, vol.82, n.1, pp.46-48.  Epub Oct 28, 2024. ISSN 0028-3746.  https://doi.org/10.35366/114230.

Necrotizing fasciitis is an aggressive skin and soft tissue infection that can rapidly spread through the perifascial planes. It has a high morbidity and mortality and requires aggressive surgical treatment initially to reduce associated morbidity and mortality. The case of a 53-year-old male with a history of diabetes mellitus II who presents a cervical abscess after a tonsillectomy, it evolves to cervical and thoracic fasciitis, drainage of the abscess and open tracheostomy are performed in another hospital. He came to our institute with a dehiscent wound, discharge of purulent material, and air leakage from the tracheostomy site. During the procedure, a 4 cm orifice is identified on the anterior wall of the trachea, debridement and placement of negative pressure therapy is performed. Subsequently, a flap is mobilized over the tracheal orifice, and a Montgomery cannula is placed to close the cervical wound. Control bronchoscopy shows a good tracheal lumen, without stenosis or air leak. It is important in a patient with necrotizing fasciitis to have aggressive surgical treatment initially, taking care of the following principles: adequate drainage of all collections, and debridement of all necrotic tissue and taking care not to contaminate adjacent structures.

Keywords : trachea; fasciitis; Montgomery.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )