Necrotizing Soft Tissue Infections

Description: Wheeless' Textbook of Orthopaedics - necrotizing fascitits is any necrotizing soft tissue infection spreading along fascial planes, with or without overlying cellulitis; - also called Meleney ulcer, NF is severe manifestation of lymphangitis that progresses in a frightening manner within a few hours; - tissue necrosis develops rapidly behind advancing wall of inflammation that limits penetration by antibiotics; - desquamation followed by gangrene may be relentless; - clinical signs of pain, hyperyrexia, and chills are severe; - skin lesions are incised and drained or aspirated to obtain fluid for culture; - initial findings are localized pain and minimal swelling, often w/ no visible trauma or discoloration of the skin; - dermal induration and erythema eventually become evident; - eventually the patient has limited range of motion, chills, fever; - dx is confirmed when a probed can be passed laterally along fascial cleft in a open wound; - blistering of the epidermis is a late finding;