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A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
Published on: July 13, 2019
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Necrotizing fasciitis after central venous catheter placement
Nico Leibig1, Christoph Hirche, Volker J Schmidt
1Department of Plastic, Hand and Reconstructive Surgery, Burn Center, BG Unfallklinik Ludwigshafen, University of Heidelberg , Ludwigshafen, Germany .
Surgical Infections
|December 11, 2014
Summary
Necrotizing fasciitis (NF) is a rare complication following central venous line placement in critically ill patients. Early recognition of local signs is crucial for prompt treatment in sedated patients.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Surgical Pathology
Background:
- Necrotizing fasciitis (NF) typically arises from skin lesions but can occur post-procedure.
- Critically ill, intubated, and sedated patients present diagnostic challenges for NF.
- Central venous line placement is an unusual but potential trigger for NF.
Observation:
- A case of NF developed in a 71-year-old male post-spine surgery after subclavian central venous line insertion.
- Initial signs of redness and swelling at the insertion site were misdiagnosed as extravasation.
- Deterioration of local symptoms prompted suspicion and diagnosis of NF.
Findings:
- Radical debridement was immediately performed upon diagnosis of NF.
- Subsequent surgical intervention included free-flap transfer and skin grafting for defect closure.
- The patient's critical condition and sedation masked typical NF symptoms.
Implications:
- Highlights the risk of NF in sedated ICU patients with central venous lines.
- Emphasizes the need for vigilance regarding iatrogenic soft tissue infections in this population.
- Suggests that predisposing factors in ICU patients may increase NF susceptibility.
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