Necrotizing fasciitis in a plastic surgery unit: a report of ten patients from Ilorin

Abstract

Background : Diffuse necrotizing fasciitis is the most treacherous soft tissue infection particularly because it may masquerade as simple cellulitis, thereby delaying diagnosis and treatment. Necrotizing fascitis correspond to deeper burns and require resuscitation, early debridement and skin coverage. It runs a rapid clinical course. Method : Ten patients with necrotizing fascitis were managed in the division of plastic and reconstructive surgery at the University of Ilorin Teaching Hospital, Nigeria. The hospital records of these patients were reviewed and form the basis of this report. Result : The duration of symptoms ranged between one day and three weeks. Most patients presented with associated high grade fever and rigor. Four of the patients had pre-morbid state which could have predisposed them to the infection. They were managed with intravenous fluids, antibiotics and analgesics, most patients had extensive debridement with subsequent wound dressing before skin grafting. Five patients survived while the remaining five died with a crude mortality of 50%. Conclusion : Early diagnosis, aggressive surgical intervention combined with supportive therapy is crucial to the successful treatment of the disease. If we must reduce the high mortality rate of the condition in our sub-region, early referral to a burns team should be considered as a treatment option by clinicians dealing with such cases.