Study of surface area involvement as a mortality indicator in necrotizing fasciitis
Journal Title: MedPulse -International Medical Journal - Year 2015, Vol 2, Issue 8
Abstract
Objective: The objective of this study was to determine the importance of involved surface area by Necrotizing fasciitis as a mortality indicator in patients presenting with Necrotizing Fasciitis. This prospective study was conducted at Government medical college, Nagpur, over a period of two years from March 2008 to May 2010. Methods: This is a prospective study. Total 64 patients were enrolled for study. The sample was divided into 2 groups: survivors and non survivors. The involvement of body surface area was calculated using Lund and Browder chart. After resuscitation, the patients underwent the emergency, aggressive surgical debridement. Post-operatively, the patients were managed in surgical wards. The patients requiring post operative specialized services (e.g. skin grafting) were referred to respective specialties (e.g. plastic surgery unit). The patients were then followed up in outpatients department. Results: The common clinical manifestations include redness, swelling, abscess formation, pain, fever, skin necrosis and foul smelling discharge etc. Necrotizing fasciitis has mortality of 14 (22%) in present study. 22 (34.375%) patients have less than 5 % of body surface area involvement. The most common predisposing factor associated was Diabetes mellitus whereas the most commonly involved site was perineum. The P value was found to be 0.001. There is significant linear correlation found between involved surface area by Necrotizing fasciitis with mortality. All patients underwent aggressive and extensive surgical debridements. The common additional procedures included Skin grafting, Secondary suturing, and Orchidectomy. Conclusion: Involvement of more body surface area in necrotizing fasciitis is associated with increase mortality.
Authors and Affiliations
Hedawoo J B, Sarve G N
Keywords
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