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Colegio de Medicina Interna de México.

2022, Number 3

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Med Int Mex 2022; 38 (3)

Necrotizing soft tissue infections. How to identify, classify and treat them?

Tuta-Quintero E, Rueda-Rodríguez A, Mantilla-Flórez YF

Language: Spanish
References: 78
Page: 595-605
PDF size: 238.29 Kb.


ABSTRACT

Necrotizing soft tissue infections are known as a rare surgical emergency, mainly affecting subcutaneous fasciae with rapidly evolving necrosis and potentially fatal systemic involvement. In the early stages the clinical presentation is characterized by skin lesions and disproportionate pain, in advanced stages the systemic compromise is typical. LRINEC (Laboratory Risk Indicator for NECrotizing Fasciitis Score) is used in clinical practice to calculate the risk for necrotizing fasciitis; however, it must be correlated with clinical manifestations and diagnostic images. Due to its rapid spread associated with high mortality, diagnostic images should not delay adequate medical management. Aggressive surgical debridement within the first 6-12 hours after admission, broad-spectrum antibiotic management and adequate fluid resuscitation are fundamental items in the management of this condition, the definitive diagnosis is achieved by tissue biopsy during surgical debridement. Multidisciplinary intervention has significant impact mortality and optimizes treatment.


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