Necrotizing fasciitis: early awareness and principles of treatment.

Necrotizing fasciitis is a serious life-threatening disease. A series of 11 patients with this disease is described, with emphasis on clinical diagnosis, initiating factors, associated diseases, etiologic pathogens and treatment. The following conclusions can be drawn from this report: Escherichia coli was the most prominent single pathogen, hyperbaric oxygen did not show any added beneficial effect, and diabetes mellitus did not affect morbidity and mortality. There is no doubt that aggressive and radical surgical excision and repeated debridement, combined with i.v. antibiotics and hyperalimentation, are essential to achieve a favorable outcome in this fulminant disease.