Clinical analysis of diagnosis and treatment of necrotizing fasciitis

Abstract

It is difficult to diagnose necrotizing fasciitis early. In addition, untimely or incorrect treatment worsens the disease, which may then develop into severe necrotizing fasciitis. A retrospective analysis of the clinical data of 35 patients with severe necrotizing fasciitis admitted to the Burn Department of Gansu Provincial Hospital from 1 January 2015, to 1 January 2020, and the etiology, causes and diagnosis of their aggravated conditions was performed. Thirty cases were directly or indirectly related to trauma, 4 cases were pressure sores caused by long-term paraplegia, and 1 case was from mosquito bites on the left side of the chest. The preliminary diagnosis of 24 patients was unclear, and these cases were misdiagnosed as cellulitis or skin infections; 11 patients were diagnosed at the early stage, but due to the incorrect treatment or failure of timely treatment, their condition was further aggravated and developed into critical necrotizing fasciitis. 1. The diagnosis of necrotizing fasciitis mainly depends on clinical manifestations, and early diagnosis is key; 2. When the patient has local trauma accompanied by local inflammation, fever or hypothermia, necrotizing fasciitis should be highly suspected, and a differential diagnosis should be made between necrotizing fasciitis and cellulitis. The affected tissue should be thoroughly debrided and drained to avoid necrosis spreading to the distal limb along the fascial space. 3. Necrotizing fasciitis should be treated with systemic comprehensive treatment, rational use of antibiotics, correction of water and electrolyte disturbance, early active and thorough debridement and effective wound closure.