Necrotizing Soft Tissue Infections: A Focused Review of Pathophysiology, Diagnosis, Operative Management, Antimicrobial Therapy, and Pediatrics

Surg Infect (Larchmt). 2020 Mar;21(2):81-93. doi: 10.1089/sur.2019.219. Epub 2019 Oct 4.

Abstract

Background: Necrotizing fasciitis is a major health problem throughout the world. The purpose of this review is to assist providers with the care of these patients through a better understanding of the pathophysiology and management options. Methods: This is a collaborative review of the literature between members of the Surgical Infection Society of North America and World Society of Emergency Surgery. Results: Necrotizing fasciitis continues to be difficult to manage with the mainstay being early diagnosis and surgical intervention. Recognition of at-risk populations assists with the initiation of treatment, thereby impacting outcomes. Conclusions: Although there are some additional treatment strategies available, surgical debridement and antimicrobial therapy are central to the successful eradication of the disease process.

Keywords: fasciitis; infection; necrotizing.

Publication types

  • Systematic Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Clostridium Infections / physiopathology
  • Clostridium Infections / therapy
  • Debridement / methods
  • Fasciitis, Necrotizing / blood
  • Fasciitis, Necrotizing / diagnosis
  • Fasciitis, Necrotizing / physiopathology*
  • Fasciitis, Necrotizing / therapy*
  • Humans
  • Risk Assessment
  • Risk Factors
  • Soft Tissue Infections / blood
  • Soft Tissue Infections / diagnosis
  • Soft Tissue Infections / physiopathology
  • Soft Tissue Infections / therapy*
  • Staphylococcal Infections / physiopathology
  • Staphylococcal Infections / therapy
  • Staphylococcus aureus
  • Streptococcal Infections / physiopathology
  • Streptococcal Infections / therapy
  • Streptococcus pyogenes

Substances

  • Anti-Bacterial Agents