Four-Year Experience with Treatment Protocol for Odontogenic Necrotizing Fasciitis

Odontogenic infections, irrespective of regional economic conditions, are a global health concern. Some cases escalate to severe levels, complicating treatment, endangering lives, and reducing positive outcomes. Necrotizing fasciitis is particularly lethal, with purulent collections and infection-derived gases spreading to distant regions. Prompt surgical intervention is crucial, especially in patients with comorbidities like diabetes mellitus. This paper introduces a comprehensive treatment approach taken in Angola over the past 4 years. This protocol involves four key steps: combined antibiotic therapy (ceftriaxone, metronidazole, and aminoglycoside), prompt drainage with aggressive debridement, irrigation with sodium hypochlorite, and rapid removal of the infectious focus. This study reports its application in 13 patients over a 10-day period, demonstrating its efficacy in odontogenic necrotizing fasciitis. The protocol significantly reduced fatalities, and its success was acknowledged by the maxillofacial surgery department at Josina Machel Hospital. Challenges, such as a scarcity of maxillofacial surgeons, prompted innovative adaptations to treatment protocols. Although lacking statistical validation, the used protocol showcased effectiveness in treating odontogenic necrotizing fasciitis. Its emphasis on combined antibiotic therapy, aggressive surgical interventions, and specialized irrigation demonstrated notable success in reducing mortality rates.