Necrotizing Fasciitis: A Study of 48 Cases

Singh, Gurjit; Bharpoda, Pragnesh; Reddy, Raghuveer

doi:10.1007/s12262-013-0835-2

Cited by 22 publications

(19 citation statements)

References 20 publications

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“…11 Singh G et al, in their study of 48 cases in 2015 observed that most of the patients were in the age group of 40-60years. 12 In the present study also most of the patients were in the age group of 40-60years.…”

Section: Discussionsupporting

confidence: 56%

“…This is very similar to present observation of lower extremity being the most common site of involvement, followed by upper extremity and perineum. 12 Stone et al in their study in 1972 observed perineum as the most common site, followed by lower extremity. 11 In the present study perineum was involved in only 11.67% of cases.…”

Section: Discussionmentioning

confidence: 93%

“…However, crepitus (12.5 %) was not a common finding. 12 David et al, in 1996 observed swelling and pain in 75% and 72.9% respectively. Other clinical findings included erythema (66%), foul discharge (46%), induration (45%), crepitus (36.5%), skin necrosis (31%), fever (31%) and blistering (23.7%).…”

Section: Discussionmentioning

confidence: 95%

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Necrotizing fasciitis: a tertiary centre based study

2018

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Background: Necrotizing fasciitis is a limb or life-threatening, invasive soft-tissue infection, although known since ancient times was first described in 1871. The purpose of the present study is to analyze the clinical presentation, bacterial flora, predisposing and co-morbid conditions, surgical and resuscitative treatment and outcome of this soft tissue infection.Methods: This is a prospective, cross-sectional, clinical study which was conducted from May 2016 until April 2018. This study included 60 consecutive patients. Age, gender, clinical presentation, co-morbid conditions and predisposing factors and pus culture sensitivity, treatment given, and its outcome were recorded.Results: With a male female ratio of 2.33:1 and median age of 46, most involves site was lower limb. Most patients presented with history of trauma followed by swelling (100%), pain (91.67%), and pus discharge (48.33%). Group A streptococcus was the most common organism isolated in both monomicrobial (53.85%) and polymicrobial (63.83%) cultures. Diabetes was the most common co morbidity observed. Fasciotomy and debridement were the mainstay of treatment with amputation rate of 23.33% and a mortality of 25%.Conclusions: Timely surgical intervention in the form of fasciotomy and debridement along with correction of malnutrition and anemia can be crucial in saving lives and limbs.

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Section: Discussionsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 93%

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Necrotizing fasciitis: a tertiary centre based study

2018

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“…Diabetes also cause defective phagocytosis, decreased cellular immunity and micro-vascular disease with resultant ischaemia. 18,19 The patients with necrotising fasciitis can present with erythema, swelling, pain, induration, discharge, bullae formation and warmth. In our study, the patients commonly presented with warmth, induration and bullae formation (40%).…”

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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“…Necrotising fasciitis is polymicrobial in nature, with most cultures yielding a mixture of aerobic and anaerobic organisms (table 1). Early diagnosis of necrotising fasciitis and aggressive treatment with surgical debridement and antibiotics determine its outcome 3. Despite excellent healthcare in developed western countries, a fulminant course of necrotising fasciitis with disabling outcomes can still occur.

Risk factors for necrotising fasciitis

Immunosuppression: medication (such as steroids, chemotherapy, infliximab) or disease (AIDS, malignancy, tuberculosis) induced

Cardiovascular diseases: arteriosclerosis, congestive heart failure, renal failure

Trauma: fractures, surgery, insect/animal bites, frostbite, intravenous drug abuse

Skin diseases: systemic lupus erythematosus, abscess, psoriasis, varicella

Gastrointestinal: diverticulitis, perirectal abscess or perforated viscus

Other: diabetes mellitus, obesity, pregnancy, advanced age

…”

Section: Descriptionmentioning

confidence: 99%