Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
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