Author(s): Oruganti Shankar1, Awais Ghori2, P. Niranjan3
Necrotizing fasciitis (NF) is a rare, life-threatening, mixed, synergistic gangrenous bacterial infections characterized by rapidly spreading inflammation and necrosis of the skin, subcutaneous tissue, and superficial fascia. Necrotizing Fasciitis needs early diagnosis, immediate extensive surgical debridement, antimicrobial treatment and nutritional support. AIM: This study aims at early detection of Necrotizing Fasciitis by tissue biopsy to enable appropriate management. MATERIALS AND METHODS: Total 29 patients were included in study taking inclusion and exclusion criteria. To aid in establishment of clinical diagnosis, tissue biopsy from skin and deep soft tissue was taken from the suspected area with induration, erythema or necrosis to confirm histological diagnosis. RESULTS: The incidence of Necrotizing Fasciitis is seen highest in age group 41 to 60 years. Male to Female ratio is 22:7. Most common predisposing factor is minor trauma (44.83%) followed by snake bites (24.14%). Average duration between onset of symptoms and first surgery is 3.7days. Klebsiella was the most common microorganism grown on the aerobic culture media. Diabetes (37.93%) is the common co- morbid condition came across in this study. Duration of hospital stay is approximately 8 to 61 days with an average around 29 days. Mortality rate is 13.8%. CONCLUSION: Necrotizing Fasciitis is a fatal disease and its early recognition is crucial for the outcome. Repeating procedures are often needed in order to check for evidence of progressive tissue necrosis and to remove the source of systemic toxins. It demands decision making, if limb can be salvaged and proceed as required. Mortality is high.