Abstract
Necrotizing soft tissue infections (NSTIs) rank among the more difficult disease processes encountered by physicians and surgeons, are aggressive infections that can result in severe disability or death. This study consist of 50 patients with necrotizing soft tissue infections were admitted to Mamata general hospital in Khammam, Telangana state during last 5 years period. Patients of both sexes aged between 20-70 years are included in this study. NSTI is more prevalent in female and also common in old age patients suffering with diabetes. Risk factors include chronic disease like diabetes, lower extremity venous insufficiency, old age, obesity/ malnutrition, immunocompromised, alcoholism, drug abuse, pregnancy. NSTIs most commonly seen in the perineum, extremities, genitalia, with fewer arising on the chest or the abdomen. Most of infections are associated with bacterial infections and commonly isolated organism is streptococcus. The average time from initiation of symptoms to hospital admission was 5 days. Wound closure was begun as soon as the infection was controlled, and often was started early-2 to 4 days after initial debridement. Forty patients successfully achieved wound closure during initial hospitalization, an average of 27 days after initial debridement and ten patients were discharged from the hospital with open wounds, left to close by secondary intention. Early diagnosis, hospital admission and surgical debridement helps in treatment of disease and decreases the mortality rates.
Keywords- Necrotizing, soft tissue, infections, risk factors, fasciitis, mortality.
References
1. Timo W. Hakkarainen, Nicole M. Kopari, Tarn N. Pham and Heather L. Evans,Necrotizing soft tissue infections: Review and current concepts in treatment, systems of care, and outcomes.CurrProbl Surg. 2014 Aug; 51(8): 344–362.
2. Hasham S, Matteucci P, Stanley PRW et al. Necrotising fasciitis. BMJ2005;330:830-832
3. Bernal NP, Latenser BA, Born JM et al. Trends in necrotizing acute softtissue infection patients 2000-2008. Burns 2012;38:252-60.
4. Morgan MS. Diagnosis and management of necrotic singfasciitis: amultipara metric approach. J Hosp Infect 2010;75:249-57.
5. Descamps V, Aitken J, Lee M. Hippocrates on necrotizing fasciitis. Lancet. 1994; 344: 556.
6. Loudon I. Necrotizing fasciitis, hospital gangrene, and phagedena. Lancet. 1994;344:1416–141.
7. Wall D, Kleain S, Black S, de Virgilio C. A simple model to help distinguish necrotizing from non-necrotizing soft-tissue infections. J Am Coll Surg. 2000;191(3):227–231.
8. Wall D, de Virgilio C, Black S, Klein S. Objective criteria may assist in distinguishing necrotizing fasciitis from nonnecrotizingsift-tissue infections. Am J Surg. 2000;179(1):17–21.
9. Wong C, Khin L, Heng K, Tan K, Low C. The LRINEC (laboratory risk indicator for necrotising fasciitis) score: a tool for distinguishing necrotising fasciitis from other soft-tissue infections. Crit Care Med. 2004;32(7):1535–1541.
10. Miller L, Carrick M, Scott B, Hodges J, Pham H. Necrotizing fasciitis caused by community-associated methicillin-resistant Staphylococcal aureus in Los Angeles. N Engl J Med. 2005;352(14):1445–1453.
11. Shiroff A, Herlitz G, Gracias V. Necrotizing soft tissue infections. J Intensive Care Med. 2014;29(3):138–144
12. McHenry C, Piotrowski J, Petrinic D, Malangoni M. Determinants of mortality for necrotizing soft-tissue infections. Ann Surg. 1995;221:558–565.
13. Kobayashi L, Konstantinidis A, Shackelford S, et al. Necrotizing soft tissue infections: delayed surgical treatment is associated with increased number of surgical debridements and morbidity [internet]. J Trauma. 2011; 71(5):1400–1405.
14. Baskin LS, Carroll PR. Cattolica EV, et al. Necrotising soft tissue infectionsOf the perineum and genitalia. Br J Urol 1990; 65:524-529.
15. Clayton MD, Fowler JE, Sharifi R, et al. Causes, presentation andsurvival of fifty-seven patients with necrotizing fasciitis of the malegenitalia. SurgGynecolObstet 1990; 170:49-55.
16. Ward RG, Walsh MD. Necrotizing fasciitis: 10 years experienceina district general hospital. Br J Surg 1991; 78:488-489.
17. Patino JF, Castro D. Necrotizing lesions ofsoft tissues: a review. WorldJ Surg 1991; 15:235-239.
18. David C. Elliott, Joseph A. Kufera and Roy A. M. Myers. Necrotizing Soft Tissue Infections Risk Factors for Mortality and Strategies for Management. Annals of surgery 1996, Vol. 224, No. 5, 672-683.
DOI: https://dx.doi.org/10.18535/jmscr/v5i2.49
