Necrotizing soft tissue infection is a potentially life-threatening infection involving any of the soft tissue layers that is associated with necrotizing changes. Risk factors include immunocompromised status, older age, obesity, and bacterial introduction. Diagnosis is clinical based on features such as skin bullae, swelling, discoloration, induration, subcutaneous emphysema, fever, shock, and organ failure. Operative findings include greyish necrotic fascia, lack of resistance to dissection, lack of bleeding, and foul-smelling pus. The LRINEC score distinguishes necrotizing fasciitis from severe cellulitis using 6 laboratory criteria points. Aggressive treatment
2. introduction
Necrotising soft tissue infection is a
potentially life-threatening infection involving
any of the layers within the soft tissue
compartment (dermis, subcutaneous tissue,
superficial fascia, deep fascia, or muscle) that
are associated with necrotizing changes
4. Clinical findings
Diagnosis by clinical
Features:
Skin bullae, swelling, oedema
Discoloration ischemic patches, cutaneous
gangrene
Dermal induration and erythema
Subcutaneous emphysema gas forming
organisms
6. findings
Systemic features:
Fever, Shock, Organ failure
Operative:
presence of greyish necrotic fascia
lack of resistance of normally adherent muscular fascia to blunt
dissection
lack of bleeding of the fascia during dissection
presence of foul-smelling dishwater pus
7. Lrinec score
Laboratory Risk Indicator for Necrotising Fasciitis
(LRINEC) was developed to distinguish necrotizing
fasciitis from severe cellulitis or abscess
Cut-off: 6 points (92% PPV, 96% NPV)
