Necrotizing Fasciitis—The Importance of Early Diagnosis and Debridement

Abstract

Necrotizing fasciitis (NF) is a potentially life-threatening bacterial infection of the skin, deep subcutaneous tissue, and fascia. Early symptoms may be misdiagnosed as cellulitis. A hallmark symptom that distinguishes NF from cellulitis is severe local pain that is out of proportion to the size and type of the wound present. Early diagnosis and treatment of NF is imperative for a patient's survival. This article describes the pathophysiologic mechanisms, clinical manifestations, and treatment of NF, as well as implications for perioperative nursing.

Manejo da gangrena de Fournier: experiência de um hospital universitário de Curitiba

“…If a patient needs a FiO 2 of 40% outside the chamber, particular care should be given to early signs of oxygen pulmonary toxicity 39 . Psychological consequences of FS are the result of extreme pain, physical disfigurement and emotional factors like anxiety, fear, worry, anger and hopelessness 42 . The lack of emotional harmony may delay the healing process 42 .…”

“…Psychological consequences of FS are the result of extreme pain, physical disfigurement and emotional factors like anxiety, fear, worry, anger and hopelessness 42 . The lack of emotional harmony may delay the healing process 42 . Adequate analgesia, optimized nutrition and social and psychological services support to patients and their families will greatly assist in healing, both physically and emotionally 42 .…”

“…The lack of emotional harmony may delay the healing process 42 . Adequate analgesia, optimized nutrition and social and psychological services support to patients and their families will greatly assist in healing, both physically and emotionally 42 . Fournier's Syndrome, even today, continues with high mortality rates.…”

Successful Treatment of Necrotizing Fasciitis in an Upper Extremity Caused by Clostridium perfringens after Bone Marrow Transplantation

“…Necrotizing fasciitis, including gas gangrene caused by the anaerobic Gram-positive bacillus Clostridium perfringens (C. perfringens), is characterized by progressive local necrosis of the fascia, subcutaneous tissue and skin, and may lead to septicemia, disseminated intravascular coagulation (DIC) and multiple organ failure within hours or days if expeditious surgical debridement and appropriate antibiotic management are not initiated (1,2).…”

“…Necrotizing fasciitis is usually preceded by a break in the skin from a penetrating injury or surgical procedure (2), although a spontaneous variety reportedly has the highest associated mortality (3)(4)(5)(6). Recognized predisposing factors include increasing age, diabetes, liver cirrhosis, arterial insufficiency, and disease or treatment causing immunosuppression (7).…”