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Necrotizing Fasciitis Shock Syndrome by Group A Hemolytic Streptococcus: Report of 6 Cases and Clinical Management by Zhiyi Wei, Qian Wang, Yanfeng Wang, Xiangjian Fang, Yixin Zhu, Juntao Cheng

Background: To explore the comprehensive treatment of group A streptococcus haemolyticus complicated with streptococcal toxic shock syndrome (STSS) in surgery.
Methods: Six patients with Type II necrotizing fasciitis complicated with STSS were enrolled from September 2018 to October 2019 in the Burn Department at Quanzhou First Hospital. The patients were treated with early incision and reduction of tension, anti-shock, anti-infection, primary debridement and vacuum suction, maintenance of organ function, and adjustment of internal environment, secondary autologous skin graft, and early rehabilitation.
Results: Five patients were healed, while one elderly patient refused treatment.
Conclusions: We should be alert to necrotizing fasciitis caused by group A hemolytic streptococcus (GAS) infection and effectively avoid the occurrence of STSS. By making an incision to reduce tension, adopting the principle of anti-infection, and actively anti-shock, maintaining the function of internal organs and the stability of internal environment, debridement and vacuum suction in early and effective stage, followed by selfskin graft to seal the wound and early rehabilitation the treatment of Type II NF and STSS can be effectively improved.

DOI: 10.7754/Clin.Lab.2020.200801