Natalya A. Bubnova, Dr. Sci. (Med), professor of the General Surgery Department with the Clinic of the Saint Petersburg State Medical University named after I. P. Pavlov and Faculty of Medicine of Saint Petersburg State University. (Saint Petersburg)
Necrotic infection is one of the most severe and life-threatening surgical infections, characterized by rapidly progressing necrosis of superficial fascia of subcutaneous tissue and muscles and accompanied by the development of polyorganic insufficiency, as well as severe sepsis and down to collapse.
The disease is characterized by high lethality, from 20-80 percent and above.
The report presents methods of diagnostics and treatment of this dangerous disease.
Controlled surgical debridement of necrotic and diseased tissues remains the cornerstone of treatment and can increase survival in patients with necrotizing soft tissue infections. In one series, 18 patients who underwent surgical debridement more than 12 hours after hospital admission had higher amputation and mortality rates. Another investigation 25 also found higher mortality rates when diagnosis and surgical debridement were delayed. Factors noted to be critical to patient survival include prompt recognition of infection, nutritional support, surgical debridement, wound reexploration, and soft tissue coverage. 18