Abstract
Background: Necrotizing soft tissue infection (NSTIs) are the infection of soft tissue associated with necrosis. It is relatively common infection with high morbidity and mortality rate. The purpose of this study is to assess the different diagnostic methods, different mode of treatment and their outcomes
Method: Retrospectively clinical details of 80 patients diagnosed with NSTI during February 2015 to January 2017 in SKMCH, Muzaffarpur were recorded. A detailed case sheet regarding age, sex, risk factor, association with hypotension, aetiology, microbiology, complication, different method of treatment and the final outcome was prepared for each patient.. Patients were managed with the broad spectrum antibiotic; repeated debridement or fasciotomy followed by culture based antibiotic and later reconstruction by skin grafting.
Results and Conclusion: Most of the patient presented with pain and swelling. Diabetes and trauma were the most common predisposing factor. Most common organism isolated was streptococci. Early diagnosis and treatment by repeated debridement were the keys to improve survival and decrease morbidity.
Key words: Necrotizing soft tissue, Antibiotic, Fasciotomy, Skin grafting, Morbidity.
References
- O’Brien KL, Beall B and Barrett NL. Epidemiology of invasive group A streptococcal necrotizing fasciitis. Clin Infect Dis. 2004; 36:610-622.
- Kaul R, McGeer A, Low DE, Green K and Schwartz B. Population-based surveillance for group A streptococcal necrotizing fasciitis: Clinical features, prognostic indicators, and microbiologic analysis of seventyseven cases. Ontario Group A Streptococcal Study. Am J Med. 1997; 103:18-24.
- Sashi Prakash Mishra, Shivanshu Singh, and Sanjeev Kumar Gupta. Necrotizing Soft tissue Infections: Surgeon’s Perspective, International journal of inflammation, 2013, article ID 609628, 7.
- Jones, Surgical Memoirs of the War of the Rebellion :Investigation Upon the Nature, Causes and Treatment of Hospital Gangrene as Prevailed in the Confederate Armies, 1871, 1861–1865, US Sanitary Commission, NewYork, NY,USA,
- McHenry CR, Piotrowski JJ, Petrinic D, Malangoni MA. Determinants of mortality for necrotizing soft-tissue infections. Ann Surg 1995;221:558-63.
- Emily Z. Keung; Xiaoxia Liu; Afrin Nuzhad; Christopher Adams; Stanley W. Ashley; Reza Askari, Immunocompro-mised Status in Patients With Necrotizing Soft-Tissue Infection, JAMA SURG/VOL 148 (NO. 5), MAY 2013
- Hannah Watson, Sameena Hassan and Michaela Davies, Journal of Infectious Diseases 2014, 2, 5.
- Phan HH, Cocanour CS. Necrotizing soft tissue infections in the intensive care unit. Crit Care Med. 2010;38(9)(suppl):S460-S468.
- Madhumita Mukhopadhyay, Necrotizing Soft Tissue Infections: The Role of the LRINEC Score Hellenic Journal of Surgery (2016) 88:1, 31-34.
- S. Ustin and M. A. Malangoni, “Necrotizing soft-tissue infections, Critical Care Medicine, 2011, vol 39, 9, 2156-2162.
- John D Urschel, Necrotizing soft tissue infections, Postgrad Med J 1999;75:645–649.
- Centers for Disease Control and Preven-tion (CDC), “Invasive group A streptoc-occal infections—United Kingdom, 1994,” Morbidityand Mortality Weekly Report, vol.43,no.21,pp.401– 402,1994.
- M. Ogilvie and T.Miclau, Necrotizings of tissue infections of the extremities and back” Clinical Orthopaedicsand Related Research, no.447,pp.179–186,2006.
- B. Hart, R. C. Lamb, and M. B. Strauss, “Gas gangrene. I: a collective review,” Journal of Trauma, vol. 23, no. 11, pp. 991– 1000,1983.
- A. Present, R. Meislin, and B.Shaffer, “ Gas gangrene: a review,” Orthopaedic Review, 1990, 19, 4, 333-341.
- Adrienne J. Headley, Necrotizing Soft Tissue Infections: A Primary Care Review, American family physician, 2004, 68, 2.
Corresponding Author
Santosh Kumar Sharma, MS
Department of General Surgery, Sri Krishna Medical College and Hospital,
Muzaffarpur, Bihar- 842004
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.