Necrotizing fasciitis: microbiological characteristics and predictors of postoperative outcome

Eur J Med Res. 2009 Jan 28;14(1):30-6. doi: 10.1186/2047-783x-14-1-30.

Abstract

Objective: Necrotizing fasciitis is a life threatening soft-tissue infection with a high morbidity and mortality. Prompt treatment based on extensive surgical debridement and antibiotic therapies are the therapeutic principles.

Methods: The medical records of patients with necrotizing fasciitis (n = 26) from 1996 to 2005 were retrospectively analyzed.

Results: The localization of necrotizing fasciitis was most commonly the trunk (42.3 %). Type I polymicrobial infection was the dominating infection. The involvement of anaerobic bacteria was associated with an increase in the number of surgical revisions (p = 0.005). Length of postoperative intensive care unit stay, duration of postoperative ventilation and mortality were significantly increased in the ASA IV-V group. Computed tomography displayed only a limited significance as diagnostic tool for initial diagnosis.

Conclusions: In severe cases the combination of necrotic skin and soft tissue gas facilitates the correct diagnosis, which should than be followed by immediate - and most often - repeated debridement. If anaerobes are isolated an early and aggressive second look is necessary.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Bacteria, Anaerobic / isolation & purification*
  • Critical Care
  • Debridement
  • Fasciitis, Necrotizing / diagnosis
  • Fasciitis, Necrotizing / microbiology*
  • Fasciitis, Necrotizing / mortality
  • Fasciitis, Necrotizing / therapy
  • Female
  • Germany / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Reconstructive Surgical Procedures
  • Reoperation
  • Respiration, Artificial
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Bacterial Agents