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Necrotizing Fasciitis (cont.)

Necrotizing Fasciitis Surgery

Rapid surgical debridement of infected tissue is the cornerstone of treatment in cases of necrotizing fasciitis. Early detection and prompt surgical intervention has been shown to decrease morbidity and mortality, underscoring the importance of early surgical involvement and consultation.

  • Extensive surgical debridement of all necrotic tissue is required. Wide and deep incisions may be necessary to excise all infected tissue (fascia, muscle, skin, etc) until healthy, viable tissue is visualized.
  • Repeated surgical debridement is often necessary within the ensuing hours to days after the initial surgical intervention, as progression of the disease may sudden, severe, and unrelenting. Sepsis may lead to other infection sites and those areas may need surgical intervention, resulting in some patients requiring multiple amputations.
  • In some cases, despite repeated surgical debridement, a life-saving amputation may be necessary if the necrosis is too widespread and the imminent risk of overwhelming sepsis and death is felt to be present.
  • Management of necrotizing fasciitis generally requires a multidisciplinary approach, involving surgeons (and various surgical subspecialties depending on the location of the infection), infectious-disease specialists, critical-care specialists, pathologists, and others to provide comprehensive care to these patients.
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