Necrotizing fasciitis

Abstract

Necrotizing fasciitis (NF) is among the most challenging surgical infections faced by a surgeon. The difficulty in managing this entity is due to a combination of difficulty in diagnosis, and also of early as well as late management. For the patient, such a diagnosis means prolonged hospital stay, painful dressings, an extended recovery, and in some unfortunate cases even loss of limb or life. Necrotizing fasciitis is a fairly common condition in surgical practice in the Indian context resulting in a fairly large body of clinical experience. This article reviews literature on MEDLINE with the key words "necrotizing," "fasciitis," and "necrotizing infections" from 1970, as well as from articles cross referenced therein. The authors attempt to draw comparisons to their own experience in managing this condition to give an Indian perspective to the condition.

Keywords: Fasciitis; necrotizing necrotising infections; synergistic infections.

Figure 1

Necrotising fasciitis involving the leg

Figure 2

Necrotising fasciitis appearing as patchy necrosis

Figure 3

Necrotising fasciitis gluteal region

Figure 4

Necrotising fasciitis gluteal region after desloughing

Figure 5

(a) Necrotising fasciitis leg, after initial debridement. (b) after application of meshed split skin graft