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Postprocedural necrotizing fasciitis: a 10-year retrospective review
Aaron T Miller1, Payam Saadai, Alexander Greenstein
1Division of General Surgery, The Mount Sinai Hospital, New York, New York 10029, USA.
The American Surgeon
|May 17, 2008
Summary
Necrotizing fasciitis (NF) is a severe infection that can occur after medical procedures. This study suggests postprocedural NF warrants its own classification due to distinct characteristics compared to community-acquired cases.
Area of Science:
- Infectious Diseases
- Surgical Complications
- Microbiology
Background:
- Necrotizing fasciitis (NF) is a life-threatening soft tissue infection with high mortality rates (25-60%).
- NF can arise as a complication following invasive medical procedures.
- Distinguishing postprocedural NF from community-acquired NF is crucial for appropriate management.
Purpose of the Study:
- To retrospectively analyze cases of postprocedural NF.
- To compare postprocedural NF with community-acquired NF.
- To determine if postprocedural NF should be a distinct clinical subcategory.
Main Methods:
- A 10-year retrospective study (1996-2006) was conducted.
- International Classification of Diseases, 9th Revision codes were used to identify NF and gas gangrene cases.
- Eleven patients who developed NF post-procedure without other causes were included.
Main Results:
- Seven patients had elective and four had semi-emergent initial procedures.
- The time from procedure to NF diagnosis varied widely (3 days to over 3 months).
- Multiple bacteria were isolated, and most patients required repeated debridements; four patients died.
Conclusions:
- Postprocedural NF is a rare but serious complication of invasive procedures.
- Significant differences exist between postprocedural and community-acquired NF.
- Postprocedural NF should be classified as its own subcategory.