Advanced Research In Diagnosis And Treatment Of Necrotizing Fasciitis

Necrotizing fasciitis(NF),a life-threatening rare infection of the soft tissues,is a medical and surgical emergency.It is characterized by necrosis of the fascia and subcutaneous tissue,accompanied by severe systemic toxicity,the rate of disability and mortality is very high(20.3% to 26% and 15% to29%,respectively)due to the rapid development of the disease.Necrotizing fasciitis has been divided into four types on the basis of microbiological cultures,and in most cases are polymicrobial.The risk factors include diabetes,hypertension,cirrhosis,age above 60,peripheral vascular disease,autoimmune diseases,etc.The erythema,swelling,and pain appear early in the disease,and blisters appear in the middle of the skin due to ischemia.The critically patients can present the symptoms and signs of septic shock and multiple organ dysfunction.The difficulty of making an early diagnosis is due to the paucity of cutaneous findings early in the course of the disease,resulting in delay of the diagnosis of the disease.The auxiliary examinations such as ultrasound,CT,MRI,and the LRINEC score can help diagnosis.The finger test is considered to be the best way for diagnosis of NF.Broad-spectrum antibiotics should be used early in treatment,and early debridement are essential.Comprehensive treatment and surgical wound management play an important role in the prognosis of the disease.Hyperbaric oxygen therapy and Vacuum sealing drainage has been proven to help early wound healing.