Authors: Henning Ryssel Günter Germann Oliver Kloeters Christian Andreas Radu Matthias Reichenberger Emre Gazyakan
Publish Date: 2010/05/25
Volume: 130, Issue: 12, Pages: 1515-1522
Abstract
Worldwide the incidence of necrotizing fasciitis NF is on the rise This rapidly progressive infection is a true infectious disease emergency due to its high morbidity and mortality The mainstay of therapy is prompt surgical debridement intravenous antibiotics and supportive care with fluid and electrolyte management Because of its high mortality rate patients are increasingly referred to burn centres for specialized wound and critical care issuesThe overall survival rate was 96 with an average length of hospital stay of 640 ± 55 days The time until the first operation was 13 days The average age of the patients was 567 ± 106 years The patients averaged 16 relevant comorbidities One patient who had five comorbidities died The affected total body surface TBS averaged 82 ± 21Early recognition and treatment remain the most important factors influencing survival in NF Yet early diagnosis of the condition is difficult due to its similarities with other softtissue disorders Repeated surgical debridement and incisional drainage continues to be essential for the survival However these infections continue to be a source of high morbidity mortality and significant healthcare resource consumption These challenging patients are best served with prompt diagnosis immediate radical surgical debridement and aggressive critical care management Referral to a major burn centre may help to provide optimal surgical intervention wound care and critical care management
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