Objective To summarize the pathogen distribution and antibiotic resistance characteristics of 69 cases of necrotizing fasciitis(NF),providing evidence to support early clinical antimicrobial therapy.Methods A retrospective analysis was conducted on microbial culture and antibiotic susceptibility test results from 69 NF cases treated in the Department of Trauma Repair and Burn Plastic Surgery,Liuzhou Workers'Hospital from January 2017 to December 2023.Results A total of 77 bacterial strains were cultured,including 24 Gram-positive bacteria,48 Gram-negative bacteria,and 5 fungi.Monomicrobial infection was predominant,accounting for 66.07％of the cases.Among the Gram-positive bacteria,Staphylococcus aureus was the most common,separated out 10 strains(12.99％),followed by Streptococcus pyogenes in 5 strains(6.49％).Among the Gram-negative bacteria,Klebsiella pneumoniae(13 strains,16.88％)and Escherichia coli(10 strains,12.99％)were most frequently identified.A total of 18 multidrug-resistant strains were found,representing 23.38％of all isolates.Gram-positive bacteria were most sensitive to vancomycin,linezolid,and tigecycline,while Gram-negative bacteria showed the greatest sensitivity to meropenem,cefoperazone,and ertapenem.Conclusion In the study area,Klebsiella pneumoniae is the most common pathogen causing NF.The initial antimicrobial regimen should include vancomycin combined with meropenem,which may significantly enhance the effectiveness of infection control.

Objective To summarize the pathogen distribution and antibiotic resistance characteristics of 69 cases of necrotizing fasciitis(NF),providing evidence to support early clinical antimicrobial therapy.Methods A retrospective analysis was conducted on microbial culture and antibiotic susceptibility test results from 69 NF cases treated in the Department of Trauma Repair and Burn Plastic Surgery,Liuzhou Workers'Hospital from January 2017 to December 2023.Results A total of 77 bacterial strains were cultured,including 24 Gram-positive bacteria,48 Gram-negative bacteria,and 5 fungi.Monomicrobial infection was predominant,accounting for 66.07％of the cases.Among the Gram-positive bacteria,Staphylococcus aureus was the most common,separated out 10 strains(12.99％),followed by Streptococcus pyogenes in 5 strains(6.49％).Among the Gram-negative bacteria,Klebsiella pneumoniae(13 strains,16.88％)and Escherichia coli(10 strains,12.99％)were most frequently identified.A total of 18 multidrug-resistant strains were found,representing 23.38％of all isolates.Gram-positive bacteria were most sensitive to vancomycin,linezolid,and tigecycline,while Gram-negative bacteria showed the greatest sensitivity to meropenem,cefoperazone,and ertapenem.Conclusion In the study area,Klebsiella pneumoniae is the most common pathogen causing NF.The initial antimicrobial regimen should include vancomycin combined with meropenem,which may significantly enhance the effectiveness of infection control.

Objective:To explore the clinical effect of X-N advancement flap in repairing pressure ulcer on the buttock or back.Methods:From June 2018 to June 2019, 20 patients with grade Ⅳ pressure ulcers on the buttock or back were hospitalized and treated in the Department of Traumatology, Burns and Plastic Surgery of Fourth Affiliated Hospital of Guangxi Medical University, including 15 males and 5 females, aged 48-89 years. The area of the patient′s wound was 8 cm×5 cm-15 cm×12 cm after debridement, and all were repaired with the X-N advancement flap designed by the author. The flap was designed according to the direction of skin relaxation on both sides of the wound, and the skin was incised in X-shape and sutured in N-shape. The width and advancement distance of the flap were recorded, and the ratio of the advancement distance to the width of the flap was calculated. The flap survival, complication, and follow-up were observed and recorded.Results:The width of the flap was (5.9±1.2) cm, the advancement distance of the flap was (10.3±2.5) cm, and the ratio of the advancement distance to the width of the flap was 1.8±0.4. All the flaps survived, and none of the flaps had blood flow disorder. Local dehiscence occurred in the flap of one patient 1 week after surgery, which was healed after laying on the floating bed, strengthened care, and wound dressing change. The flap of one patient developed infection 5 days after surgery, which was healed after partial suture removal, smooth drainage, and replacement with sensitive antibiotics. The wounds of the remaining 18 patients were all cured. After 3 months of follow-up, the flaps survived well with good elasticity and texture.Conclusions:The X-N advancement flap can make the skin and soft tissue move forward effectively. It is simple and effective to repair pressure ulcers on the back or buttock of patients with this flap, which is worthy of clinical promotion and application.

Objective To compare the efficacy of the reforming endoscopic minimally invasive releasing(REMIR) with open procedure for treatment of carpal tunnel syndrome.Methods Senventy patients with unilateral carpal tunnel syndrome were randomly divided into REMIR group and open procedure group,with 35 cases in each group.Kelly's standard,two-point discrimination,operation time and complication occurrence were compared between the two groups.Results All patients were followed-up for 12 months.There was no significant difference in the therapeutic results and in the improvement of two-point discrimination between the two groups (P ＞ 0.05 ).The operation time of REMIR group was significantly shorter than the open procedure group ([ 10.03 ± 1.84] min vs [37.63 ±7.18]min,t =22.210,P ＜0.001 ).And there was no cases with scar tenderness in REMIR group while there was 7 cases in open procedure group.Conclusion Compared with the open procedure,the REMIR method has the same clinical efficacy while with the advantages of causing smaller skin scar and being less time consuming.