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Necrotizing fasciitis: a preventable disaster

T M Rouse, M A Malangoni, W J Schulte

    Surgery
    |October 1, 1982
    PubMed
    Summary
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    Necrotizing fasciitis (NF) is a severe infection with a high mortality rate, often linked to chronic diseases and delayed treatment. Early recognition and intervention are critical for improving patient survival outcomes.

    Area of Science:

    • Infectious Diseases
    • Surgical Pathology
    • Critical Care Medicine

    Background:

    • Necrotizing fasciitis (NF) is a rapidly progressive soft tissue infection with significant morbidity and mortality.
    • Commonly associated with perineal disease, surgical procedures, and cutaneous ulcers.
    • Polymicrobial infections are frequent, often occurring in patients with comorbidities.

    Purpose of the Study:

    • To analyze the clinical characteristics, treatment outcomes, and mortality factors of necrotizing fasciitis.
    • To identify risk factors and predictors of survival in patients with NF.
    • To evaluate the preventability of postoperative necrotizing fasciitis.

    Main Methods:

    • Retrospective review of 28 cases of necrotizing fasciitis in 27 patients.

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  • Analysis of causative factors, comorbidities, treatment delays, surgical interventions, and patient outcomes.
  • Correlation of clinical variables with mortality and survival rates.

    • Main Results:

    • The overall mortality rate was 73%, with death often resulting from persistent sepsis or systemic complications.
    • Delayed treatment (over 12 hours) was associated with a significantly higher mortality rate (11 of 12 deaths).
    • Survival was more likely in patients with localized NF and those requiring fewer debridements.

    Conclusions:

    • Prompt diagnosis and aggressive treatment are paramount for improving survival in necrotizing fasciitis.
    • Chronic debilitating diseases increase the complexity and mortality risk of NF.
    • Adherence to surgical principles can prevent postoperative necrotizing fasciitis.