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Eur J Med Res. 2009 Jan 28;14(1):30-6.

Necrotizing fasciitis: microbiological characteristics and predictors of postoperative outcome.

Author information

1
Department of General Surgery, Heinrich Heine University, Moorenstr. 5, 40225 Duesseldorf, Germany. andreas.krieg@med.uni-duesseldorf.de

Abstract

OBJECTIVE:

Necrotizing fasciitis is a life threatening soft-tissue infection with a high morbidity and mortality. Prompt treatment based on extensive surgical debridement and antibiotic therapies are the therapeutic principles.

METHODS:

The medical records of patients with necrotizing fasciitis (n = 26) from 1996 to 2005 were retrospectively analyzed.

RESULTS:

The localization of necrotizing fasciitis was most commonly the trunk (42.3 %). Type I polymicrobial infection was the dominating infection. The involvement of anaerobic bacteria was associated with an increase in the number of surgical revisions (p = 0.005). Length of postoperative intensive care unit stay, duration of postoperative ventilation and mortality were significantly increased in the ASA IV-V group. Computed tomography displayed only a limited significance as diagnostic tool for initial diagnosis.

CONCLUSIONS:

In severe cases the combination of necrotic skin and soft tissue gas facilitates the correct diagnosis, which should than be followed by immediate - and most often - repeated debridement. If anaerobes are isolated an early and aggressive second look is necessary.

PMID:
19258208
PMCID:
PMC3352202
DOI:
10.1186/2047-783x-14-1-30
[Indexed for MEDLINE]
Free PMC Article

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