[Necrotizing dermatitis, infections of soft tissue and deep fascia: classification and treatment]

Nectrotizing fasciitis is a mixed infection of skin and subcutaneous tissue with a characteristic clinical and pathological appearance. Necrotizing soft tissue infections, caused by aerobic, anaerobic and mixed bacterial flora are an increasing problem in medical and surgical practice. The apparently wide variety of these infections is systematized. Etiology and bacteriology are discussed, as the role of surgery, antibiotics and hyperbaric chamber in the treatment of the infections. Early and radical surgical excision of all affected tissue is the treatment of choice. Adjuvant hyperbaric oxygen appears to be important in refractory progressive bacterial gangrene. A combination of hyperbaric oxygen, surgical treatment and antibiotics gives the lowest mortality and morbidity in gas gangrene compared with other treatment modifications. Extensive clinical experience shows the efficacy of these treatment protocols.