Diabetes mellitus is the most common co-morbidity associated
with necrotising fasciitis. This study aims to compare the clinical
presentation, investigations, Laboratory Risk Indicator for Necrotising
Fasciitis (LRINEC) score, microbiology and outcome of management
of this condition in diabetic and non-diabetic patients. The medical records of all patients with surgically proven necrotising
fasciitis treated at our institution between 2005 and 2014 were
reviewed. Diagnosis of necrotising fasciitis was made on findings
of ‘dishwater’ fluid, presence of greyish necrotic deep fascia and
lack of bleeding on muscle dissection found intra-operatively. Information
on patients’ demographics, presenting symptoms, clinical signs,
investigations, treatment and outcome were recorded and analysed.Aims
Patients and Methods
The concept and method of repeatedly connecting an extracorporeal blood pump to produce elevated pancycle inflow pressures to ischaemic limbs is presented. The aim of this study was to determine if intermittent increased perfusion would improve the clinical picture in peripheral arterial disease. Animal studies—to determine the safety and efficacy of the pumping and the access device were performed on 12 sheep. Following successful completion of that study, pilot studies of 18 patients were treated using the Peripheral Access Device (PAD) and Hypertensive Extracorporeal Limb Hyperperfusion (HELP). Treatment was offered to patients who had no other alternative than major amputation. Patients were treated for less than 100 hours of total pumping, broken over three or less treatment periods over approximately one week. Improvement was measured by pain scores, clinical examination and digital thermography.Introduction
Methods
