Diagnosis and Treatment of Necrotizing Fasciitis

Background: necrotizing fasciitis is a rare, rapidly progressive infection that is difficult to diagnose. Objective: to describe the results obtained from the diagnosis and treatment in a group of patients with necrotizing fasciitis. Methods: a prospective case series study was conducted in eleven patients diagnosed with necrotizing fasciitis treated at the Department of Orthopedics and Traumatology at the Julio Aristegui Villamil Hospital from January 2008 to June 2010. Diagnosis was established by finger test. Results: male patients (72, 7%) of white skin (81, 8%) aged 36 to 50 years (63.3 %) predominated. Time between admission and diagnosis of necrotizing fasciitis was 4.6 days (+/- 1.02). Diabetes mellitus was the most frequently associated condition (45.4%). There was a direct portal of entry in 63.6 % of cases and gram-positive aerobic bacteria were the most common. The number of interventions for debridement of the necrotic tissue ranged from four to nine times. Ninety point nine percent of the patients needed a meshed skin autograft or allograft. Hospital stay was 37 days (28.4 +/- 9.1) and mortality was 9, 09%. Conclusions: early diagnosis of necrotizing fasciitis is very important for prognosis.