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ISSN 1025-0255 (Electronic)

2015, Number 6

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AMC 2015; 19 (6)

Necrotizing fasciitis

Hernández GEH, Mosquera BG, de la Rosa SV

Language: Spanish
References: 31
Page: 654-664
PDF size: 432.82 Kb.


ABSTRACT

Background: necrotizing fasciitis is the most challenging surgical infection that surgeons face. The complex management is due to the combination of difficulties for the diagnosis and treatment.
Objective: to update and systematize knowledge about a devastating disease that is a challenge for surgeons.
Method: a review of the literature from the last five years was made. Six original articles, nine case reports and seven bibliographic reviews were included. There was particular attention to classification, pathogeny, diagnosis and treatment.
Development: necrotizing fasciiatis is an uncommon, progressive, deadly infection that can affect any part of the body but it is more frequent in extremities, especially the legs. It is mostly polimicrobial and affects the superficial fascia, the subcutaneous tissue, the subcutaneous fat with nerves, arteries, veins and the deep fascia. The infection progresses rapidly in few days. Microbiology, radiography and magnetic resonance imaging are the most used complementary studies. The diagnosis is mainly clinical. The treatment includes support hemodynamic measures, an extensive early surgical debridement and the use of antimicrobials, besides the general care.
Conclusions: necrotizing fasciiatis is an uncommon but potentially deadly disease that can affect any part of the organism. A great level of suspicion is needed due to the pause of the specific cutaneous manifestations. The antecedents and the clinical manifestations are key elements for the diagnosis. Immediate aggressive surgery is compulsory. In spite of all the measures taken, mortality is really high.


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