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. 2016 May 27:11:21.
doi: 10.1186/s13017-016-0080-7. eCollection 2016.

Review of 58 patients with necrotizing fasciitis in the Netherlands

Sander F L van Stigt  1 , Janneke de Vries  2 , Jilles B Bijker  3 , Roland M H G Mollen  4 , Edo J Hekma  5 , Susan M Lemson  6 , Edward C T H Tan  1
Affiliations

Review of 58 patients with necrotizing fasciitis in the Netherlands

Sander F L van Stigt et al. World J Emerg Surg. .

Abstract

Background: Necrotizing fasciitis is a rare, life threatening soft tissue infection, primarily involving the fascia and subcutaneous tissue. In a large cohort of patients presenting with Necrotizing fasciitis in the Netherlands we analysed all available data to determine the causative pathogens and describe clinical management and outcome.

Methods: We conducted a retrospective, multicentre cohort study of patients with a necrotizing fasciitis between January 2003 and December 2013 in an university medical hospital and three teaching hospitals in the Netherlands. We only included patients who stayed at the Intensive Care Unit for at least one day.

Results: Fifty-eight patients were included. The mortality rate among those patients was 29.3 %. The central part of the body was affected in 28 patients (48.3 %) and in 21 patients (36.2 %) one of the extremities. Most common comorbidity was cardio vascular diseases in 39.7 %. Thirty-nine patients (67.2 %) were operated within 24 h after presentation. We found a type 1 necrotizing fasciitis in 35 patients (60.3 %) and a type 2 in 23 patients (39.7 %).

Conclusions: Our study, which is the largest study in Europe, reaffirmed that Necrotizing fasciitis is a life threatening disease with a high mortality. Early diagnosis and adequate treatment are necessary to improve the clinical outcome. Clinical awareness off necrotizing fasciitis remains pivotal.

Keywords: ICU; LRINEC score; Necrotizing fasciitis; Outcome; Soft tissue infections; The Netherlands.

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Figures

Fig. 1
Fig. 1
A 65 year old women with a history of diabetes mellitus, renal insufficiency and corticosteroid use, presented on the emergency room with fever, progressive pain, erythema and swelling in her left leg (a). Surgical debridement showed typical signs of necrotizing fasciitis. Two weeks after presentation and 10 days after VAC therapy, she has got a split skin graft (b). Follow up after 3 months (c) and 5 months (d) showed a well-healed wound
See this image and copyright information in PMC

References

    1. Wong CH, Wang YS. The diagnosis of necrotizing fasciitis. Curr Opin Infect Dis. 2005;18:101–6. doi: 10.1097/01.qco.0000160896.74492.ea. - DOI - PubMed
    1. Morgan MS. Diagnosis and management of necrotizing fasciitis: a multiparametric approach. J Hosp Infect. 2010;75:249–57. doi: 10.1016/j.jhin.2010.01.028. - DOI - PubMed
    1. McHenry CR, Piotrowski JJ, Petrinic D, Malangoni MA. Determinants of mortality for necrotising soft tissue infections. Ann Surg. 1995;221:558–65. doi: 10.1097/00000658-199505000-00013. - DOI - PMC - PubMed
    1. Tilkorn DJ, Citak M, Fehmer T, Ring A, Hauser J, Al Benna S, et al. Characteristics and differences in necrotizing fasciitis and gas forming myonecrosis: a series of 36 patients. Scand J Surg. 2012;101(1):51–5. doi: 10.1177/145749691210100110. - DOI - PubMed
    1. Su Y-C, Chen H-W, Hong Y-C, Chen C-Y, Hsiao C-T, Chen I-C. Laboratory risk indicator for necrotizing fasciitis score and the outcomes. ANZ J Surg. 2008;78:968–72. doi: 10.1111/j.1445-2197.2008.04713.x. - DOI - PubMed

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