Conventional methods of western medicine for treating necrotizing fasciitis of ankle

Conventional methods of Western medicine for treating necrotizing fasciitis of the ankle:

1. Antibiotics: Necrotizing fasciitis of the ankle joint is a mixed infection of various bacteria, aerobic bacteria and anaerobic bacteria. Symptoms of systemic poisoning occur early and the condition is serious. Antibiotics should be used in combination. Metronidazole is highly effective against Bacillus fragilis. Combination with clindamycin can control Bacillus fragilis; aminoglycosides such as gentamicin, tobramycin, and amikacin can control Enterobacter; ampicillin is sensitive to enterococci and anaerobic peptostreptococci; cephalosporins such as ceftriaxone and ceftriaxone have a broad antibacterial spectrum and are effective against aerobic and anaerobic bacteria.

2. When debridement and drainage of diseased tissue and thrombosis in surrounding blood vessels are extensive and difficult for drugs to reach, and active high-dose antibiotic treatment for 1 to 3 days has no obvious effect, surgical treatment should be performed immediately.

Necrotic fascia and subcutaneous tissue should be separated by fingers. Commonly used methods:

1. Remove healthy skin from the infected area for later use: remove necrotic tissue and clean the wound; free skin graft to cover the wound. This method can prevent a large amount of serum from leaking out of the wound and is conducive to maintaining the balance of body fluids and electrolytes after surgery.

2 Make multiple longitudinal incisions on healthy skin: remove necrotic fascia and adipose tissue, rinse the wound with 3% hydrogen peroxide, metronidazole solution or 0.5%~1.5% potassium permanganate solution to create an environment that is not conducive to the growth of anaerobic bacteria; then use yarn wet compresses with antibiotic solutions such as metronidazole, gentamicin, etc., and change the dressing every 4 to 6 hours.

3. Choose skin grafting: When the skin defect is large and difficult to heal on its own, choose skin grafting after the inflammation subsides.

During surgery, care should be taken to protect healthy fascia, as damage can easily lead to the spread of infection. Local wet compresses of metronidazole can slow skin growth, but long-term use is not recommended.

3. Supportive treatment actively corrects water and electrolyte disorders. Patients with anemia and hypoproteinemia can be transfused with fresh blood, albumin or plasma; nasogastric or intravenous nutrition is rich, and elemental diet can ensure adequate calorie intake.