M A Malangoni1. 1. Department of Surgery, Case Western Reserve University School of Medicine, MetroHealth Medical Center Campus, Cleveland, Ohio 44109, USA. mmalangoni@metrohealth.org
Abstract
BACKGROUND: Necrotizing soft tissue infections are a group of diseases with significant associated mortality. A wide spectrum of bacteria can be involved, and diagnosis can be difficult. METHODS: Review of pertinent literature of the diagnosis and therapy of necrotizing soft-tissue infection. RESULTS: Mortality and other adverse outcomes are directly related to advanced age, the presence of organ system failure, lactic acidemia, the percentage of body surface area involved with infection, and delays in operative management. Patients usually die early from the consequences of septic shock, whereas late mortality is related to multiple organ failure. CONCLUSION: Early recognition and treatment can lower mortality from necrotizing soft tissue infection. Prompt operative debridement, broad-spectrum antimicrobials, and physiologic support are important components of treatment.
BACKGROUND:Necrotizing soft tissue infections are a group of diseases with significant associated mortality. A wide spectrum of bacteria can be involved, and diagnosis can be difficult. METHODS: Review of pertinent literature of the diagnosis and therapy of necrotizing soft-tissue infection. RESULTS: Mortality and other adverse outcomes are directly related to advanced age, the presence of organ system failure, lactic acidemia, the percentage of body surface area involved with infection, and delays in operative management. Patients usually die early from the consequences of septic shock, whereas late mortality is related to multiple organ failure. CONCLUSION: Early recognition and treatment can lower mortality from necrotizing soft tissue infection. Prompt operative debridement, broad-spectrum antimicrobials, and physiologic support are important components of treatment.
Authors: Lillian S Kao; Debbie F Lew; Samer N Arab; S Rob Todd; Samir S Awad; Matthew M Carrick; Michael G Corneille; Kevin P Lally Journal: Am J Surg Date: 2011-05-04 Impact factor: 2.565