Necrotising soft tissue infections of the perianal and perineal region: Risk factors, diagnosis and treatment

Abstract

Necrotizing soft tis sue in fec tion is a life-threat ening con di tion, char ac ter ized by ex ten sive ne cro sis of skin, sub cu ta ne ous, fas cia and mus cle. 82% of pa tients ex hibit some of the risk fac tors, such as di a be tes mellitus, obe sity and al co hol ism, smoking, im mu no de fi ciency, mal nu tri tion or low so cioeco nomic sta tus. The necrotizing soft tis sue in fection is ini tially di ag nosed by a clin i cal examination. The use of im ag ing, par tic u larly com puted tomog ra phy, rep re sents a golden stan dard; the CT exam usu ally shows the pres ence fluid col lec tions, abscess, ad i pose tis sue de gen er a tion and sub cu ta ne ous em phy sema. The treat ment of necrotizing soft tis sue in fec tion in volves sur gi cal debridement, drain age, wide in ci sions of the af fected area, tis sue de com pression and ap pli ca tion of broad-spec trum antimicrobial ther apy. De spite ex ist ing mod ern meth ods of treatment, or the so-called prin ci ple of "source con trol", the mor tal ity is still up to 51%. Necrotizing soft tis sue in fec tion is a very dan ger ous in fec tion we should always be aware of, and treat it as early as pos si ble.