INFECCIÓN NECROTIZANTE DE TEJIDOS BLANDOS: EXPERIENCIA DURANTE 15 AÑOS EN UN HOSPITAL PEDIÁTRICO
Angélica Paulos¹, Catalina Arredondo², Leonor Muñoz³, Carolina Lagos⁴, Valentina Broussain⁵, Andrea Hasbún⁶, María José Hurtado⁵.

¹ Cirujano Pediatra, Magíster en Salud Pública, Hospital de Niños Dr. Roberto del Río, Santiago-Chile.
² Alumna de Medicina, Universidad Finis Terrae, Santiago-Chile.
³ Becada de Cirugía Pediátrica, Hospital de Niños Dr. Roberto del Río, Universidad de Chile, Santiago-Chile.
⁴ Cirujano Pediatra, Magíster en Docencia, Hospital de Niños Dr. Roberto del Rio, Santiago-Chile.
⁵ Cirujano Pediatra, Hospital de Niños Dr. Roberto del Rio, Santiago-Chile.
⁶ Cirujano Plástico, Hospital de Niños Dr. Roberto del Rio, U. de Chile, Santiago-Chile.

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Introduction: Necrotizing soft tissue infection (NSTI) has a high morbidity and mortality. The objective of this study is to describe the perioperative management of children under 15 years of age who have had this condition for 15 years in a pediatric hospital.
Material and methods: cases series of patients identified by Pathological Anatomy with NSTI during 2000 and 2015 at the Dr. Roberto del Río Hospital. Demographic variables, treatment, antecedents of vaccination, surgeries, complications, microorganisms, follow-up, and deaths are described.

Results: 22 patients were identified, with a median of 2 years 9 months of age (interquartile range: 13 months to 5 years y 10 months). 50% of the cases were associated to chickenpox. Two died. No patient was previously vaccinated against varicella zoster virus. The location was trunk (14), extremities (7) and neck (1). All conscious patients presented cutaneous hyperesthesia. Surgical debridement was performed with a median of 6.8 hours from the onset of hyperesthesia and 2 hours from diagnostic suspicion. The most frequent microorganisms were: Streptococcus pyogenes (38%) and Escherichia coli (31%). The most frequent antibiotics used were penicillin plus clindamycin. The wound was handled with primary closure, grafts and / or flaps. Five patients evolved with sequelae that needed treatment.

Conclusion: It was identified that STNI in children is associated with chickenpox. It should be suspected in cutaneous lesions and disproportionate hyperesthesia. Aggressive resection is essential for treatment.