Necrotizing fasciitis a prospective study of 18 cases at al yarmouk teaching hospital

Abstract EN

Background : necrotizing Fasciitis is a progressive, rapidly spreading, inflammatory infection located in the deep fascia, with secondary necrosis of the subcutaneous tissues Polymicrobial infection is the most common finding in necrotizing fasciitis rather than a single causative organism.

Although diabetes mellitus is the most common predisposing risk factor, other conditions may predispose to such immune-compromisation such as cancer, alcoholism, vascular diseases, organ transplantation, HIV...etc.

Patients and Methods: Eighteen cases of Necrotizing Fasciitis were followed prospectively as inpatients in the surgical dept.

in Al Yarmouk teaching hospital, and followed later on at the outpatient clinic or in the plastic surgery clinic and department.

Most of them were treated with successive wound excisions.

All were covered with one or more parenteral antibiotic and antimicrobial therapy.

Intensive care unit services were needed on several occasions and sometimes more than once for the same patient.

Mortality was the end result in three of the cases.

Most of patients needed plastic surgical procedures to cover the defects yielded after wound excision.

All the data estimated out of these cases were tabulated and certain incidences were estimated.

The results were compared with some of the published literatures to come into conclusions or guidelines for the management of such condition.

Results : Eighteen cases of necrotizing Fasciitis were admitted to the surgical dept.

of our hospital ; fifteen (83.3 %) males and three (16.7 %) females.

Age ranges 19-65 years, with mean age 45.2 years.

Of these 77.8 % were 30-60 years ages.

In male patients 7 (38.8%) were scroto-penile region, 6 (33.3 %) perianal region, 2(11.1 %) gluteal region.

While in female patients 1(5.56 %) for labial, perianal & gluteal regions.

Conclusion: Necrotizing Fasciitis is an uncommon condition, characterized by deep aggressive, gangrenous and necrotizing soft tissue infection.

Unless it is rapidly and aggressively managed with in a well-equipped surgical unit supported by an intensive care unit, it may end lethally by progressive multi-organ failure.