RISK FACTORS FOR NECROTIZING FASCIITIS AND ITS OUTCOME AT A TERTIARY CARE CENTRE

Yogendra Gupta, Manisha Chhetry, Kamal Raj Pathak, Ranjib Kumar Jha, Nischal Ghimire, Bibhuti Nath Mishra, Navin Kumar Karn, Ganesh Kumar Singh, Jatindra Nath Bhagabati

Abstract


Background: Necrotizing fasciitis (NF) is a serious and potentially fatal condition where there is rapid progression of inflammation of skin, subcutaneous tissue, and superficial fascia and can be mono-microbial or poly-microbial. The disease is rapidly progressive in nature and if not promptly treated leads to significant morbidity or even mortality. This study was designed to explore the various risk factors commonly present and study the outcome of the disease. Methods: This was a cross sectional study done in tertiary centre over period of one year from April 2014 to March 2015. Patient admitted with soft tissue infection were presumptively made diagnosis of NF based on clinical features and final diagnosis was made after pre-operative surgical findings. Results: Forty two (40.38%) patients had final diagnosis of NF out of 102 soft tissue infections. Twenty-nine (69%) of 42 patients with NF fully recovered with surgical and medical management. Eleven (26.2%) of these patients succumbed to their illness and two (4.8%) needed amputation of limb to control the infection. The most common co-morbid condition was alcoholism, followed by diabetes mellitus. Conclusion: The incidence of necrotizing fasciitis in patients admitted with soft tissue infection was 40.38%. Mortality and morbidity due to this condition was found to be high.

Keywords: necrotizing fasciitis; outcome; mortality; morbidityBackground:

Necrotizing fasciitis (NF) is a serious and potentially fatal condition where there is rapid progression of inflammation of skin, subcutaneous tissue, and superficial fascia and can be monomicrobial or polymicrobial. The disease is rapidly progressive in nature and if not promptly treated leads to significant morbidity or even mortality. This study was designed to explore the various risk factors commonly present and study the outcome of the disease.

 

Methods:

This was a prospective observational study done in tertiary center over period of one year from April 2014 to March 2015. Patient admitted with soft tissue infection were presumptively made diagnosis of NF based on clinical features and final diagnosis was made after preoperative surgical findings.

 

Results:

 Forty two (40.38%) patients had final diagnosis of NF out of 102 soft tissue infections .Twenty-nine (69%) of 42 patients with NF fully recovered with surgical and medical management. Eleven (26.2%) of these patients succumbed to their illness and two (4.8%) needed amputation of limb to control the infection. The most common co-morbid condition was alcoholism, followed by diabetes mellitus.

 

 Conclusion:

The incidence of necrotizing fasciitis in patients admitted with soft tissue infection was 40.38%. Mortality and morbidity due to this condition was found to be high.

 

Keywords: necrotizing fasciitis, outcome, mortality, morbidity

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References


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