ABSTRACT

Objective:

Patients who were diagnosed with necrotizing fasciitis and those who were treated with topical negative pressure (TNP) after debridement and those who were not treated with TNP were reviewed.

Material and Methods:

Patients were evaluated regarding to age, gender, etiology, predisposing factors, infection localizations, treatment methods and findings.

Results:

Out of the 39 patients treated for diagnosis of fasciitis between January 2005 and November 2010; 13 were treated with topical negative pressure (TNP) (Group A), and 26 were treated standard wet dressing (Group B). Mean age was 48.8 (16-77) in Group A; and 51.1 (24-79) in Group B. The most frequent etiological factors in Group A were urogenital lesions in five cases (38.4%) in Group A, and anorectal lesions in fourteen cases (53.8%) in Group B. The most frequent predisposing factor in both cases was diabetes (61.5% in Group A, and 38.4% in Group B). In wound cultures; Pseudomonas aeruginosa was the most frequent causative agent (46.1%) in Group A, and Escherichia coli (57.6%) in Group B. Wide surgical debridement followed by antibiotic therapy was performed to all patients. More than one debridement was required in 32 cases (82.5%). The average number of debridement was 3.6 in Group A, and 2.1 in Group B. Four of the six cases, on whom loop colostomy was performed, were in Group A; and two of them were in Group B. The defects after the debridements were repaired with grafts or local flaps. Overall mortality was 23%, mortality of each group was 30% and 19% in Group A and B respectively.

Conclusion:

Early diagnosis and treatment in necrotizing fasciitis with high mortality and morbidity are life-saving. TNP application accelerates wound healing by increasing local blood flow, accelerating granulation tissue growth, and edema and exudates control.