A clinical analysis of necrotizing fasciitis: a review of 54 cases

Necrotizing fasciitis is a severe and sometimes life-threatening soft tissue infection that is characterized by rapidly widespreading necrosis of fascia and subcutaneous tissue. Fifty-four cases of necrotizing fasciitis were reviewed over a 5-year period. Among them, 25 patients (46%) had diabetes mellitus. The majority of the wound bacterial cultures (71%) yielded a mixed growing. There were negative cultures in six patients, and single organism growth in 14 patients (29%). The predominant organisms growth were Streptococci, Staphylococci, and Escherichia coli. The overall mortality rate was 22% (12/54). Death was caused by systemic septic complications in these patients. All 12 mortalities resulted from delayed debridement (averaging 25 days after initial symptoms appeared). Our study indicates that the early recognition and prompt debridement of all necrotic tissue is essential for reducing the mortality rates of this potentially lethal condition.