Indian Journal of Critical Care Medicine
An open access publication of ISCCM™ 
 
Users online: 14 
     Home | Login 
  About Current Issue Archive Search Instructions Online Submission Subscribe Etcetera Contact  
  Navigate Here 
 »   Next article
 »   Previous article
 »   Table of Contents

 Resource Links
 »   Similar in PUBMED
 »  Search Pubmed for
 »  Search in Google Scholar for
 »Related articles
 »   Citation Manager
 »   Access Statistics
 »   Reader Comments
 »   Email Alert *
 »   Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed10744    
    Printed216    
    Emailed8    
    PDF Downloaded610    
    Comments [Add]    
    Cited by others 2    

Recommend this journal

 

 RESEARCH ARTICLE
Year : 2006  |  Volume : 10  |  Issue : 4  |  Page : 225--229

Necrotizing fasciitis: A decade of surgical intensive care experience


Department of Anesthesia, Hamad Medical Corporation, Doha, Qatar

Correspondence Address:
Nissar Shaikh
Department of Anesthesia/ICU and Pain Mgt, Hamad Medical Corporation, P.O. Box 3050, Doha
Qatar
Login to access the Email id


DOI: 10.4103/0972-5229.29840

Get Permissions

Necrotizing fasciitis is a rare disease, potentially limb and life-threatening infection of fascia, subcutaneous tissue with occasionally muscular involvement. Necrotizing faciitis is a surgical emergency with high morbidity and mortality. Aim: Aim of this study was to analyze presentation, microbiology, surgical, resuscitative management and outcome of this devastating soft tissue infection. Materials and Methods: The medical records of necrotizing fasciitis patients treated in surgical intensive care unit (SICU) of our hospital from Jan 1995 to Feb 2005 were reviewed retrospectively. Results: Ninety-four patients with necrotizing fasciitis were treated in the surgical intensive care unit during the review period. Necrotizing fasciitis accounted for 1.15% of total admissions to our SICU. The mean age of our patients was 48.6 years, 75.5% of the cases were male. Diabetes mellitus was the most common comorbid disease (56.4%), 24.5% patients had hypertension, 14.9% patients had coronary artery disease, 9.6% had renal disease and 6.4% cases were obese. History of operation (11.7%) was most common predisposing factor in our patients. All patients had leucocytosis at admission to the hospital. Mean duration of symptoms was 3.4 days. Mean number of surgical debridement was 2.1, mean sequential organ failure assessment (SOFA) score at admission to SICU was 8.6, 56.38% cases were type 1 necrotizing fasciitis and 43.61% had type 2 infection. Streptococci were most common bacteria isolated (52.1%), commonest regions of the body affected by necrotizing fasciitis were the leg and the foot. Mean intubated days and intensive care unit (ICU) stay were 4.8 and 7.6 days respectively. Mean fluid, blood, fresh frozen plasma and platelets concentrate received in first 24 hours were 4.8 liters, 2.0 units, 3.9 units and 1.6 units respectively. Most commonly used antibiotics were piperacillin with tazobactum and clindamycin. Common complication was ventricular tachycardia (6.4). 46.8% patients had multi organ dysfunction, 15 of them died giving a mortality of 16% in this study. Conclusion: Necrotizing fasciitis is more common in males, diabetes mellitus was the most common comorbid disease, type 1-necrotizing fasciitis was more common and the most common regions of the body affected by necrotizing fasciitis were the leg and the foot.






[FULL TEXT] [PDF]*


        
Print this article     Email this article

Online since 7th April '04
Published by Medknow