Nicolau Syndrome after intramuscular injection of non-steroidal anti-inflammatory drugs (NSAID)
Nicolau Syndrome after intramuscular injection of non-steroidal anti-inflammatory drugs (NSAID)
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DOI：
10.17305/bjbms.2015.1.190
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发表时间：
2015-01-01
影响因子：
3.4
通讯作者：
Poyraz, Necdet
中科院分区：
文献类型：
--
作者：
Dadaci, Mehmet;Altuntas, Zeynep;Poyraz, Necdet
Nicolau综合征是一种罕见的肌肉注射并发症，导致皮肤和脂肪组织局部缺血性坏死。在本文中，我们讨论的病因，危险因素，和臀Nicolau综合征的治疗方案，指的是在我院治疗的患者。我们的研究包括17名因肌肉注射继发臀肌坏死症状来我们诊所就诊的妇女。考虑了以下变量：注射部位、给药药物、注射频率、注射人员、针头尺寸和针尖颜色。仔细分析肌内注射应用后获得的磁共振图像，以确定是否存在坏死、囊肿形成和臀脂肪组织层厚度。肌内注射的药物完全是非甾体抗炎药。平均患者BMI为41.8（所有患者均被视为肥胖），平均臀脂肪厚度为54 mm。手术中使用了标准长度的缝针（3.8 cm）。11例患者采用一期缝合，6例患者采用局部皮瓣治疗。观察到的坏死是臀肌注射位置不当的结果，其中一方面由于脂肪层的极端厚度，另一方面由于标准针头的长度不当，药物被注射到脂肪组织而不是肌肉中。肥胖患者应尽可能避免肌肉注射：如有必要，应使用适当的注射技术。
Nicolau syndrome is a rare complication of intramuscular injection that leads to local ischemic necrosis of the skin and adipose tissue. In this paper, we discuss etiologies, risk factors, and treatment options for gluteal Nicolau syndrome referring to patients treated in our hospital. Our study includes 17 women who visited our clinic with symptoms of gluteal necrosis secondary to intramuscular injection. The following variables were taken into account: injection site, drug administered, frequency of injections, the person who administered the injections, needle size, and needle tip color. Magnetic resonance images obtained in the aftermath of intramuscular injection application were carefully analyzed for presence of necrosis, cyst formation and the thickness of the gluteal fat tissue layer. Drugs that had been received in intramuscular injection were exclusively non-steroidal anti-inflammatory drugs. Mean patient BMI was 41.8 (all patients were considered as obese), and mean gluteal fat thickness was 54 mm. Standard length of needles (3.8 cm) had been used in procedures. The wounds were treated with primary closure in 11 patients and with local flap therapy in 6 patients. The observed necrosis was a consequence of misplaced gluteal injection, where drugs were injected into the adipose tissue instead of the muscle due to the extreme thickness of the fat layer, on one hand, and the inappropriate length of standard needles, on the other hand. Intramuscular injection should be avoided in obese patients whenever possible: if it is necessary, proper injection technique should be used.