| [ Summary ] |
Necrotizing fasciitis is a potentially lethal disorder of rapidly progressing fascial necrosis with widespread undermining of the skin. One percent of perirectal abscess develops into necrotizing fasciitis. Patients had a high incidence of predisposing underlying illness such as diabetes mellitus or alcoholism. Physical assessment is very important in diagnosis. The findings are characterized by an ill-defined margin of infection, and by systemic manifestations often associated with mental deterioration. Soft-tissue gas detection from plain radiographs and/or computed tomography is also useful. Several kinds of causative bacteria have been reported, but the infections are almost always caused by a combination of aerobic and anaerobic bacteria. Early diagnosis and immediate treatment are associated with a significant decrease in mortality. Treatment must begin with surgical debridement of all infected and devitalized tissue including the skin, subcutaneous tissue, and fascia Wide spectrum systemic antibiotic coverage is mandatory, although it cannot be overemphasized that definitive therapy must include immediate operative intervention. |