A Study of Predictive Factors in the Outcome of Necrotizing Fasciitis in Patients of Sepsis

Abstract

Background: Necrotizing fasciitis is an infection occurring in the deep fascial layers. It is a progressive infection. The diagnosis of necrotizing fasciitis is usually clinical and is important to find it early as it is a fast spreading infection. Necrotizing fasciitis occurs as a result of necrosis of skin and subcutaneous layer. The aim of the study is to assess factors which will help in clinching the diagnosis of Necrotizing Fasciitis and to identify factors responsible for morbidity and mortality. The study was hospital based observational study conducted for 2 years from May 2017- June 2019 on 30 patients with necrotizing fasciitis at Department of general surgery, Osmania General Hospital. Subjects and Methods: Clinical and anatomical findings rendered initial diagnosis. The patient’s details have been noted. Detailed patient interview on history and other comorbid conditions was conducted. Bacteriological culture is done. Following initial debridement, the wound was inspected regularly and subsequent debridement was done periodically whenever necessary. Results: Majority of the patients were males, 80% and the rest 20% were females. In 56.66% of the patients the site of NF was perineum and in the rest 43.33% of the patients it was in the extremities. The type of bacterial culture done was polyculture in majority 90% of the patients and monoculture was done in the rest 10% of the patients. 30% of the patients tested positive for NF and rest 70% were found to be negative with NF. The mortality rate was 30% and morbidity rate was 10%. Conclusion: Effective and vigorous surgical debridement, often in multiple sessions, supplemented by adequate antibiotics and supportive treatment, is the key to a successful result with necrotizing fasciitis.