Journal of Cutaneous and Aesthetic Surgery
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PRACTICE POINTS
Year : 2020  |  Volume : 13  |  Issue : 2  |  Page : 154-159

A basic algorithmic surgical approach for Nicolau syndrome


1 Department of Plastic, Reconstructive and Aesthetic Surgery, Medical Faculty, Bezmialem Vakıf University, Istanbul, Turkey
2 Department of Plastic, Reconstructive and Aesthetic Surgery, School of Medicine, Mustafa Kemal University, Serinyol Hatay, Turkey
3 Private Practice, Serinyol Hatay, Turkey

Correspondence Address:
Osman Kelahmetoğlu
Department of Plastic, Reconstructive and Aesthetic Surgery, Bezmialem Vakif University, Adnan Menderes Bulvarı Vatan Caddesi 34093 Fatih, Istanbul.
Turkey
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JCAS.JCAS_139_19

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Background: Nicolau syndrome (NS) is a rare complication that develops after the administration of intramuscular diclofenac sodium. The etiology and surgical treatments of 11 patients with NS were evaluated and studies in the literature were examined. The aim of this study was to compose a basic algorithm for surgical approaches to treat NS. Materials and Methods: Eleven patients were evaluated for NS between December 2013 and January 2018. Two patients did not accept treatment, and nine patients underwent surgical debridement of necrotic tissues. The tissue defects of five patients were closed with a fasciocutaneous flap and, in four patients, the defects were repaired primarily. Results: No complications, such as wound infection, wound dehiscence, seroma, or flap necrosis, were encountered. Of the seven patients who received concurrent antibiotic therapy, no patient had any problems at their follow-up (2–30 months). The results were satisfactory from an aesthetic and functional point of view. Conclusion: NS was more frequent in women with a high body mass index and high fat in gluteal regions. We considered that any kind of medication could lead to NS. Different methods are discussed for treatment.


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