STUDY OF THE CLINICAL PROFILES OF NECROTISING FASCIITIS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 60
Abstract
BACKGROUND Necrotising fasciitis is a rapidly progressive and soft tissue destructive inflammation and infection involving the superficial fascia and muscle. Necrotising soft tissue inflammation and infection occurs predominantly in patients predisposed by compromised immunological status, diabetes mellitus or vascular insufficiency, HIV, neutropenia, hypoproteinaemia, COPD, etc. Clinical profile of necrotising fasciitis is variable and the clinical course can be fatal. MATERIALS AND METHODS This descriptive observational study of the clinical profile of necrotising fasciitis was undertaken in a tertiary care centre of central India. Study was conducted for a period of four years i.e. from July 2011 to September 2015 on retrospective and prospective basis. The collected data was analysed by descriptive statistical methods and presented in a tabular form. RESULTS Fifty-two patients of necrotising fasciitis were included in the study and the demographic profile, clinical presentations, morbidity and mortality were studied. Necrotising fasciitis patients present with systemic manifestations and develop the complications leading to death. Four patients (7.69%) of 52 expired in spite of all efforts. Males were the common sufferers as we had 36 males of out the 52 patients. Diabetes mellitus was the commonest comorbid condition. In our study, most common organism was mixed flora in the pus culture and sensitivity followed by group A Streptococcus. Lower extremities were the commonest body parts to get necrotising fasciitis. Debridement was the most common surgical procedure performed in our study. Mean duration of hospital stay was 35.44 days. CONCLUSION Necrotising fasciitis leads to prolonged morbidity and significant mortality. Most of the patients had prolonged hospital stay and required multiple surgical procedures mainly debridement during the course of their treatment. Patients with provisional diagnosis of necrotising fasciitis should be treated aggressively with wound debridement as early as possible, if necessary, with grafting and broad-spectrum antibiotics. A high level of clinical alertness is needed in a patient with comorbid conditions presenting with the features that mimic necrotising fasciitis so that early diagnosis and early treatment can start and prevent the life of patients.
Authors and Affiliations
Sanjeev Malhotra, Abhishek Kansal, Sanjay Datey, Harshvardhan Rao
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