[Management of necrotizing cellulitis and fasciitis]

A literature review did not reveal any controlled study on the management of necrotizing fasciitis. Treatment protocol includes: - an immediate or early surgical management with debridement of all necrotic tissue and extensive fasciotomy followed by a surgical reexamination of the infected area in the following days; - an initial antibiotic therapy targeting aerobic Gram-positive and Gram-negative organisms and anaerobes (e.g: amoxicilline-clavulanic acid or vancomycin-metronidazole); - an adequate nutritional support, infusion, and resuscitation; - hyperbaric oxygen therapy may be considered as an associated treatment; but there is no randomized, controlled trial demonstrating its efficacy.