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Necrotizing fasciitis of the upper extremity
M H Gonzalez1, T Kay, N Weinzweig
1Department of Orthopaedics, University of Illinois at Chicago 60612-7342, USA.
The Journal of Hand Surgery
|July 1, 1996
Summary
Necrotizing fasciitis, a severe infection, often affects individuals with diabetes or a history of substance abuse. Early recognition and aggressive surgical debridement are crucial for managing this rapidly destructive condition.
Area of Science:
- Infectious Diseases
- Surgical Pathology
- Public Health
Background:
- Necrotizing fasciitis is a severe soft tissue infection.
- Risk factors include diabetes and substance abuse.
- Commonly associated with beta-hemolytic Streptococcus and polymicrobial infections.
Purpose of the Study:
- To retrospectively analyze cases of necrotizing fasciitis.
- To identify associated risk factors and causative agents.
- To evaluate treatment outcomes and emphasize early intervention.
Main Methods:
- Retrospective review of twelve necrotizing fasciitis cases over five years.
- Analysis of patient history, including substance abuse and diabetes.
- Documentation of causative organisms, human immunodeficiency virus status, surgical interventions, and outcomes.
Main Results:
- All cases had a history of substance abuse or diabetes.
- Eleven infections involved beta-hemolytic Streptococcus or mixed aerobic/anaerobic bacteria.
- Three of five patients tested positive for human immunodeficiency virus.
- An average of three debridements were required; two patients needed shoulder disarticulation.
Conclusions:
- Necrotizing fasciitis is strongly linked to diabetes and substance abuse.
- Prompt surgical debridement and antibiotic therapy are vital.
- Early diagnosis and aggressive management are essential to reduce severe morbidity and mortality.
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