NECROTIZING FASCIITIS - A SINGLE CENTERS EXPERIENCE

Aims. Necrotising fasciitis is a rare but serious soft tissue infectio n with high morbidity and mortality. We wished to review our 5 year ex perience with this condition 1989-94. In addition, in light of recent interest in the association between necrotising fasciitis and nonstero idal antiinflammatory drugs, we wished to determine the incidence of N SAID use in our necrotising fasciitis patients. Methods. A review of a ll Dunedin Hospital cases of necrotising fasciitis between January 198 9-June 1994 was undertaken. Subsequently all specialists involved in t reating the patients audited the notes, particularly regarding clinica l presentation, complications, treatment, outcome and concomitant use of NSAIDs was also recorded. Results. There have been seven patients ( 4 males) with a mortality rate of 43%. Survival was associated with ea rly diagnosis, rapid and intensive medical and surgical intervention, and possibly the early use of haemofiltration. Five of the seven patie nts had ingested nonsteroidal antiinflammatory drugs (NSAID) prior to their presentation which may have potentiated the severity of the endo toxic shock. Conclusion. Necrotising fasciitis remains a potentially l ethal disease but early management and aggressive treatment improves o utcome. A high index of suspicion, avoidance of NSAIDs, and aggressive multidisciplinary team management of these patients offers the best c hance of survival in necrotising fasciitis.