SP8.8 Necrotising fasciitis: A retrospective single-centre 10-year experience

Abstract

Abstract Aims Necrotizing fasciitis (NF) is a life-threatening condition with early diagnosis and goal-directed resuscitation critical to improve perioperative outcomes. The aim of this study is to review our experience and define trends in the incidence, presentation, morbidity, mortality and management of NF cases. Method Case notes from 1st October 2012 to 30 September 2022 were retrieved. Data was collected in regard to the patient demographic, risk factors, initial presentation, laboratory findings, surgical approach, length of stay in the intensive care unit (ICU), additional operation requirements and 30-day mortality. Results Medical records of 59 patients were reviewed. 58% of patients were male and patient age ranged from 24 to 84 years old with average age of presentation 53. 91% of cases had one or more risk factors identified with 36% of patients being diabetic, and 54% of patients obese. At initial presentation 51% were tachycardic, 46% had a fever and 32% were hypotensive with average CRP 313 and WCC 20. Computerized tomography (CT) was completed prior to surgical debridement in 39% of cases of which 74% of CT scans showed subcutaneous gas. 91% of cases were polymicrobial. 80% of patients required ICU support postoperatively with average length of stay of 9.8 days. 24% required defunctioning stomas and in 39% of cases, VAC dressings were applied. 30-day mortality was 10%. Conclusion Necrotising fasciitis carries a significant morbidity and mortality risk. Systemic upset is not always present at initial presentation and clinical suspicion should be increased with high CRP and WCC in the presence of known risk factors.