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Meningococcal septicaemia complications involving skin and underlying deeper tissues--management considerations and

A Numanoglu1, S W Bickler, H Rode

  • 1Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital and University of Cape Town.

South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
|December 12, 2007
PubMed
Abstract

Insights

Meningococcaemia-related purpura fulminans in children has a 10.7% mortality. Early surgical intervention, including skin-releasing incisions and delayed skin grafting for extensive necrosis, improves extremity salvage outcomes.

Area of Science:

  • Pediatric Surgery
  • Infectious Diseases
  • Wound Healing

Background:

  • Meningococcaemia can lead to purpura fulminans, a severe condition causing skin necrosis.
  • Effective management strategies are crucial for improving patient outcomes.

Purpose of the Study:

  • To detail surgical management of purpura fulminans secondary to meningococcaemia.
  • To propose a protocol for managing this condition.

Main Methods:

  • Retrospective review of 112 children with purpura fulminans admitted to intensive care.
  • Analysis of treatment, including wound care, skin grafting, and amputation.

Main Results:

  • Overall mortality was 10.7%.
  • Average skin necrosis was 14% of total body surface area, predominantly affecting lower limbs.
  • 77% of patients required skin grafting; 31.2% resolved without necrosis.

Conclusions:

  • Meningococcaemia-associated purpura fulminans has severe consequences requiring prompt surgical evaluation.
  • Early surgical interventions like releasing incisions and delayed grafting are vital for limb salvage.
  • Conservative amputation with potential revision is recommended for necrotic extremities.

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