Necrotizing fasciitis: a tertiary centre based study

Nishith M. Paul Ekka, Archana Dipa Sangita Kujur, Gaurav Mishra


Background: Necrotizing fasciitis is a limb or life-threatening, invasive soft-tissue infection, although known since ancient times was first described in 1871. The purpose of the present study is to analyze the clinical presentation, bacterial flora, predisposing and co-morbid conditions, surgical and resuscitative treatment and outcome of this soft tissue infection.

Methods: This is a prospective, cross-sectional, clinical study which was conducted from May 2016 until April 2018. This study included 60 consecutive patients. Age, gender, clinical presentation, co-morbid conditions and predisposing factors and pus culture sensitivity, treatment given, and its outcome were recorded.

Results: With a male female ratio of 2.33:1 and median age of 46, most involves site was lower limb. Most patients presented with history of trauma followed by swelling (100%), pain (91.67%), and pus discharge (48.33%). Group A streptococcus was the most common organism isolated in both monomicrobial (53.85%) and polymicrobial (63.83%) cultures. Diabetes was the most common co morbidity observed. Fasciotomy and debridement were the mainstay of treatment with amputation rate of 23.33% and a mortality of 25%.

Conclusions: Timely surgical intervention in the form of fasciotomy and debridement along with correction of malnutrition and anemia can be crucial in saving lives and limbs.


Cellulitis, Gangrene, Infection, Necrotizing fasciitis

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Decamps V, Atiken J, Lee MG. Hippocrates on necrotizing fasciitis. Lancet. 1994 Aug 20;344(8921):556.

Bosshardt TL, Henderson VJ, Organ CH. Necrotizing soft-tissue infections. Arch Surgy. 1996 Aug 1;131(8):846-54.

Wilson B. Necrotizing fasciitis. Am J Surg. 1952;18:416-31.

Kotrappa KS, Bansal RS, Amin NM. Necrotizing fasciitis. Am Fam Physician. 1996;53(5):1691-7.

Ardire L. Necrotizing fasciitis: case study of a nursing dilemma. Ostomy Wound Manage. 1997;43(5):30-4.

Harmonson JK, Lobar MY, Harkless LB. Necrotizing fasciitis. Clin Podiatr Med Surg. 1996;13(4):635-46.

Espandar R, Sibdari SY, Rafiee E, Yazdanian S. Necrotizing fasciitis of the extremities: a prospective study. Strategies Trauma Limb Reconstr. 2011 Nov;6(3):121-5.

Muqim R. Necrotizing fasciitis: Management and Outcome. J Coll Physicians Surg Pak. 2003 Dec;13(12):711-4.

Khamnuan P, Chongruksut W, Jearwattanakanok K, Patumanond J, Tantraworasin A. Necrotizing fasciitis: epidemiology and clinical predictors for amputation. Int J General Med. 2015;8:195-202.

Shaikh N. Necrotizing fasciitis: a decade of surgical intensive care experience. Indian J Critical Care Med. 2006 Oct 1;10(4):225-9.

Stone HH, Martin Jr JD. Synergistic necrotizing cellulitis. Ann Surg. 1972 May;175(5):702-11.

Singh G, Bharpoda P, Reddy R. Necrotizing fasciitis: a study of 48 cases. Indian J Surg. 2015 Dec 1;77(2):345-50.

Peer SM, Rodrigues G, Kumar S, Khan SA. A clinicopathological study of necrotizing fasciitis--an institutional experience. J Coll Physicians Surg Pak. 2007 May;17(5):257-60.

Angoules AG, Kontakis G, Drakoulakis E, Vrentzos G, Granick MS, Giannoudis PV. Necrotising fasciitis of upper and lower limb: a systematic review. Injury. 2007 Dec 1;38(5):S18-25.

Elliott DC, Kufera JA, Myers RA. Necrotizing soft tissue infections. Risk factors for mortality and strategies for management. Ann Surg. 1996 Nov;224(5):672-83.

Kwan MK, Saw A, Chee EK, Lee CS, Lim CH, Zulkifle NA, et al. Necrotizing fasciitis of the lower limb: an outcome study of surgical treatment. Med J Malaysia. 2006 Feb;61:17-20.

Cheng NC, Tai HC, Chang SC, Chang CH, Lai HS. Necrotizing fasciitis in patients with diabetes mellitus: clinical characteristics and risk factors for mortality. BMC Infectious Dis. 2015 Dec;15(1):417.