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Category: Volume 06 Issue 03 March 2018
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Title: Necrotizing Fasciitis of the Extremities– A Clinical Study

Authors: Dr K.Karthik Raja. M.S., Dr M. Prema M.S., Dr R.Baskaran.M.S.

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i3.38

Abstract

Necrotizing fasciitis is a rapidly progressive fulminant infection of the deep fascia and subcutaneous tissue commonly involving extremities, perineum, scrotum, penis, abdominal wall. It is associated with significant morbidity and mortality. Trauma is the most commonly identified etiology. Elderly and immunocompromised patients are the most affected. Early diagnosis and differentiation from other non-necrotising skin and soft tissue infections is needed because delay in surgical debridement leads to larger area of necrosis and higher chance of mortality. Diagnosis is dependent on clinical features like disproportionate pain, tenderness beyond skin involvement, systemic signs of toxicity like fever and tachycardia, erythema, edema, presence of bullae etc. We present our experience with 45 cases of necrotizing fasciitis of the extremities with respect to etiology and triggering factors, clinical presentation, laboratory findings and treatment outcomes in the rural Indian setting. This is a retrospective observational study conducted with the aim of analyzing the factors influencing morbidity and mortality of necrotizing fasciitis. Demographic data, presence of co-morbidities, time interval from onset of symptoms to surgical intervention, nature of organisms isolated, derangement of laboratory indicators like haemoglobin, total WBC count, blood urea,  serum creatinine, sodium levels were collected and analysed for their influence on  duration of hospital stay and area of skin necrosis that needed grafting. It was found that delay in presentation was associated with larger area of necrosis which was statistically significant. However no association was found between age, sex, site of involvement, presence of co-morbidities, history of local application of an irritant and area of necrosis.

Keywords: necrotizing fasciitis, extremities, area of necrosis, skin grafting

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Corresponding Author

Dr K.Karthik Raja. M.S.

Lecturer in Surgery, Department of Surgery, Rajah Muthiah Medical College and Hospital,

Annamalai University, Chidambaram, Tamilnadu, India

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.