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Published on: November 23, 2017
[Clinical evaluation and treatment results of 30 patients with necrotizing fasciitis]
Güzin Yeşim Ozgenel1, Selçuk Akin, Ramazan Kahveci
1Department of Plastic and Reconstructive Surgery, Medicine Faculty of Uludağ University, Bursa, Turkey. gozgenel@yahoo.com
Background:
We retrospectively evaluated patients who underwent treatment for necrotizing fasciitis within a five-year period.
Methods:
Thirty patients (4 females, 26 males; mean age 55 years; range 19 to 78 years) with necrotizing fasciitis were evaluated with respect to age, sex, etiology, predisposing factors, localization of infections, culture results, and treatment methods and results.
Results:
The most common etiologic and predisposing factors were anorectal lesions (36.7%) and diabetes (53.3%), respectively. Wound cultures yielded Pseudomonas aeruginosa in 50% of the patients. Two strains of aerobic bacteria were isolated in three patients. All patients underwent extensive surgical debridement and received antibiotic therapy. Twenty-nine patients (96.6%) required more than one debridement, with a mean of 4.5 debridements. The ensuing skin defects following debridement were reconstructed with grafts or local flaps. No complications were encountered in the postoperative period.
Conclusion:
Early diagnosis and treatment result in decreased morbidity and prevent mortality in necrotizing fasciitis.
Insights
Necrotizing fasciitis, a severe soft tissue infection, often stems from anorectal issues and diabetes. Prompt surgical debridement and antibiotics significantly improve patient outcomes, reducing complications and preventing fatalities.
Area of Science:
- Infectious Diseases
- Surgical Pathology
- Microbiology
Context:
- Necrotizing fasciitis is a rapidly progressive bacterial infection.
- Anorectal lesions and diabetes are identified as common predisposing factors.
- Pseudomonas aeruginosa is a frequent causative agent.
Purpose:
- To evaluate treatment outcomes for necrotizing fasciitis.
- To identify common etiologies and predisposing factors.
- To assess the efficacy of surgical debridement and antibiotic therapy.
Summary:
- Thirty patients with necrotizing fasciitis were analyzed.
- Anorectal lesions (36.7%) and diabetes (53.3%) were the most frequent factors.
- Aggressive surgical debridement (mean 4.5 procedures) and antibiotics were standard treatment, with high success rates and no postoperative complications.
Impact:
- Early diagnosis and intervention are crucial for reducing necrotizing fasciitis morbidity.
- Effective management strategies can prevent mortality associated with this infection.
- This study highlights the importance of timely and comprehensive treatment approaches.
