Integrated clinical care pathway for managing necrotising soft tissue infections

Shah, Amit Kumar; Kumar, Nirmal; Gambhir, Raghvinder; Chaudhry, Rajan

doi:10.1007/s12262-009-0076-6

Cited by 15 publications

(13 citation statements)

References 17 publications

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“…The microbiological profile of the patients revealed polymicrobial infections in the majority of patients, which is consistent with other studies [1,16]. The most common organisms included E. coli, Streptococcus, and Staphylococcus.…”

Section: Discussionsupporting

confidence: 90%

Necrotizing Fasciitis: A Study of 48 Cases

2013

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Necrotizing fasciitis represents a group of highly lethal infections characterized by rapidly progressing inflammation and necrosis. The aim of the study was to analyze the clinical profile, microbial flora, and predisposing risk factors in patients with necrotizing fasciitis. Lastly, we aimed to formulate a protocol for management of necrotizing fasciitis. Forty-eight cases of necrotizing fasciitis patients who reported to our hospital between April 2007 and September 2009 were included in the study. The commonest predisposing factors were age greater than 50 years (58 % cases) and diabetes mellitus (52 % cases). The commonest site involved was extremity (70.8 %). Majority of infections were polymicrobial (87.5 %). Repeated aggressive debridement was the commonest surgical procedure performed. Early and aggressive surgical debridement, often in multiple sittings, supplemented by appropriate antibiotics and supportive therapy, forms the key to a successful outcome in necrotizing fasciitis.

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Section: Discussionsupporting

confidence: 90%

Necrotizing Fasciitis: A Study of 48 Cases

2013

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“…1 In our study the most common age involved is middle age which is in correlation with other studies. [7][8][9]16,17 Males were more involved, the reason could be males are more involved in outdoor activities. In our study diabetes was the commonest co-morbid condition associated which is in correlation with other studies in literature.…”

Section: Discussionmentioning

confidence: 99%

“…This is in correlation with other studies in literature. 16 The mainstay of treatment of necrotising fasciitis is rapid surgical debridement followed by appropriate antibiotic therapy after initial resuscitation with fluid and electrolyte replacement/blood transfusion. 21 According to Wipf et al, the single most important determinant of survival is the amount of time elapsed between initial presentation and surgical debridement.…”

Section: Discussionmentioning

confidence: 99%

A prospective study of cases with necrotising fasciitis: our experience at a tertiary care teaching hospital

Mittal

Singh

Mittal³

et al. 2017

Int Surg J

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Background: Necrotising fascitis is a life-threatening infection involving fascia and necrosis of subcutaneous tissue. The portal of entry usually is trivial trauma. It requires immediate diagnosis and intervention to reduce mortality. The objective of this study was to study clinical profile, predisposing risk factors and to formulate a protocol for management of necrotising fasciitis.Methods: The study was conducted at tertiary care teaching hospital in Punjab, India catering to a semi-urban and rural (agricultural based) population over a period of three years between January 2014 to January 2017. All the consecutive patients who came to the emergency department (ER) of the institute presenting early with clinical features suggestive of NF were included in the study. The study included total 50 cases. The cases were studied in detail according to study plan that included age, sex, clinical features, results of blood and wound cultures, the number of surgical interventions, total duration of hospitalization and the mortality rate.Results: The most common age group was between 40-60yrs and there were 48 males. There was history of trivial trauma or insect bite in majority of cases. Mostly patients presented with bullae formation, induration, edema. Diabetes was the commonest comorbid condition associated. All the patients were thoroughly investigated, swab cultures were taken. Debridements were done followed by grafting. In 10 patients, we could not salvage the limb and 10 patients expired after debridement.Conclusions: Necrotising fasciitis is more common in middle aged males with diabetes. Early diagnosis and aggressive treatment is required to reduce the mortality.

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“…[14] Systemic manifestations such as hypotension, fever, tachycardia, tachypnea and laboratory findings of leukocytosis and metabolic acidosis are indices of development of sepsis. [15] Necrotizing fasciitis is commonly seen in middle age males. [1][2][3][15][16] In our study 50% of the patients were between 40-49 years.…”

Section: Discussionmentioning

confidence: 99%

“…[15] Necrotizing fasciitis is commonly seen in middle age males. [1][2][3][15][16] In our study 50% of the patients were between 40-49 years. Diabetes mellitus was the most common co-morbid condition in our study (42%), which is correlated with that in other literatures.…”

Section: Discussionmentioning

confidence: 99%

A Clinicopathological Study of Fournier’s Gangrene and Its Management: Early Debridement Better Prognosis

Singh¹,

Singh²,

Patel³

2016

jemds

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Integrated clinical care pathway for managing necrotising soft tissue infections

Abstract: Background Necrotising soft tissue infections (NSTI) are relatively common infections with high morbidity and mortality rate, as they often present late in their course. Quick and aggressive surgical treatment improves survival and decreases hospital stay.

Cited by 15 publications

References 17 publications

Necrotizing Fasciitis: A Study of 48 Cases

Necrotizing Fasciitis: A Study of 48 Cases

A prospective study of cases with necrotising fasciitis: our experience at a tertiary care teaching hospital

A Clinicopathological Study of Fournier’s Gangrene and Its Management: Early Debridement Better Prognosis

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