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Necrotizing Fasciitis of Lower Limb – Surgical Management along with Penicillin Therapy

Omkar Mahendra Shirke, Junior Resident, Department of General Surgery, Dr. D.Y. Patil Medical College, Hospital & Research Centre, Pimpri, Pune, Dr. D.Y Patil Vidyapeeth, Pune, Maharashtra 411018, India. , Shahaji Chavana , Omkar Mahendra Shirkeb , Balaji Dhaigudec , (Col) S.V. Panchbhaid , Gaurav Batrae

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New Indian Journal of Surgery 9(2):p 133-135, March - April 2018. | DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9218.4

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Abstract

Introduction: Necrotizing fasciitis represents a group of highly lethal infections characterized by rapidly progressing inflammation & necrosis. Early recognition & aggressive surgical treatment in combination with antibiotic therapy can prevent fatal consequences.

Aims and Objectives: The aim of the study was to assess the clinical profile, analyse the microbial flora & the outcome of aggressive surgical management in combination with intravenous Penicillin therapy.

Material and Methods: A prospective  study was carried out in our hospital between April 2016 to December 2017. Predisposing factors, clinical presentations, microbial flora and management amongst thirty consecutive patients who had presented to this hospital during this period were studied.

Results: Age above 45 years, trauma & diabetes mellitus were the commonest predisposing factors. All wounds had polymicrobial growth. Repeated aggressive debridement was carried out in most patients with average of 3.5 debridements per patient. Majority of the wounds healed by secondary intention. However, 30% of the patients needed skin grafting.

Conclusion: Early & aggressive surgical debridement, often in multiple sittings, supplemented by appropriate antibiotics & supportive therapy forms the key to successful outcome. Low threshold & early
referral by family physicians can prevent the potent complications of necrotizing fasciitis.

 

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DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9218.4

Keywords

Necrotizing Fasciitis; Rapidly Progressing Inflammation & Necrosis; Intravenous Penicillin Therapy; Polymicrobial Growth; Fasciotomy; Debridement.

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