Necrotizing Fasciitis

I have seen countless of pictures of the effects of a necrotizing fasciitis infection, it gives people the appearance that make it seems like they’re in the middle of a zombie apocalypse. Necrotizing Fasciitis is a very rare disease, but there are still quite a few incidences that occur every year. This type of infection is so deadly that it eats away at an individual’s soft tissue, and is known to eat a persons’ skin to the bone. This disease goes way back to the fifth century until it reappeared during the time of the civil war.

Necrotizing Fasciitis is estimated to occur in 53 percent of every one hundred thousand people. The abuse of antibiotics caused an increase of cases over the past few years. This disease can occur in the presence of any cut or wound. Hospitals that neglect to keep their facility clean can often see outbreaks of these infections throughout the facility. Necrotizing Fasciitis has also been known to occur in burns, trauma to the skin, and improperly cleaned wounds due to surgery. There are several different strains of bacteria that can cause the skin to become necrosis.

Due to the several different strains of bacteria that exist necrotizing infections are categorized as a type 1,2,3. Type 1 is a mix between aerobic and anaerobic bacteria, type 2 is caused by anaerobic, and type 3 is caused by marine vibrio’s. A study that was conducted came to a conclusion that legs and arms are the most common sites for these types of infections. In this systematic review the characteristics of necrosis affecting the upper and lower extremities, the approach of the operation, and the results of the treatment were researched.

The survival rates of these cases were also reported. Data Sources The information gathered for this review was obtained from a Medline search using the Ovid search engine. The research papers for inclusion had to be English based reports, and had to have cases that only included necrosis of the lower and upper limbs. Exclusion criteria were papers that had cases with less than ten patients. Only twelve out of one hundred and thirty-one papers were chosen to be included in the systematic review. This graph shows the overall results of the data. Author Patients Extrem.

UpperExtrem LowerExtrem Amputat Disarticul Mortality WangKun 18 18 3 (17%) 15 (73%) 1 (6%) 2 (11%) 6 (33%) Gonzales 12 12 12 (100%) 0 1 (8%) 2 (17%) 0 Tang 24 24 12 (50%) 12 (50%) 6 (25%) 0 8 (33%) Demirag 16 16 0 16 (100%) 14(88%) 2 (13%) 7 (44%) Zahar 21 21 0 0 0 0 10 (52%) Wang Tzon 19 19 0 19 (100%) 0 0 0 Anaya 96 96 0 0 25(26%) 0 0 Cheng 17 19 0 19 (100%) 5 (29%) 0 11 (65%) Huang 24 24 0 0 4 (17%) 0 2 (8%) Ozalay 22 23 0 23 (100%) 9 (41%) 0 3 (14%) Ogilvie 150 152 65 (43%) 87 (57%) 9 (6%) 0 14 (9%) Tsai 32 34 10 (31%) 24 (69%) 12(38%) 0 10 (31%) Total 451 458 102 (32%) 215 (68%) 86(20. %) 6 (1. 4%) 71(21. 9%)

Results Overall this study included four hundred and fifty-one patients, with sixty-six percent of the individuals consisting of males. The age range of the patients were between the ages of eight and eighty-eight years old. Four hundred and fifty-eight extremity cases were reviewed with two hundred and fifteen of the cases having to deal with infections of the lower limbs. The three most common clinical manifestations of necrosis are Erythema (222) patients, Pain (191) patients, and Edema which had one hundred and forty-nine patients.

The most common predisposing factor was having a history of drug abuse. Drug users that are involved with needles often find themselves using dirty needles which can cause a wound to become infected. Some of the medical conditions that are mostly associated with this type of deadly soft tissue infection are: • Diabetes • Smoking • Alcohol Abuse • Cirrhosis • Hiv The top two prevalent bacteria’s found in these infections consist of staphylococcus aureus which consisted of eight teen point nine percent, and streptococcus group A which consisted of thirteen point seven percent of individuals.

The four hundred and fifty-one patients that was studied only eighty-six of them were forced to go through an amputation of a limb. There were seventy-one cases where death was the outcome. Treatment Conclusion In my opinion Necrosis Fasciitis is one of the most fatal diseases that an individual can experience. According to the data males are more prone to obtain this type of infection than women. I personally believe that due to the fact that men being more active than women puts them at a great risk. Men are involved in more aggressive physical activities than women, such as camping, fishing, and playing sports.

These types of activities are a breeding ground for bacteria, and the chance of someone getting a cut infected is an all-time high. The data also showcases that lower extremities are more likely to be infected than upper limbs. To prevent a loss of a limb an infection of this caliber has to be acted upon immediately. The deeper the infection the harder it is to recognize. The most common sign is tenderness of the erythematous are of the cellulitis. As I stated before erythema involved in seventy-three percent of the cases. You should also look for signs of purulence, fluctuance, edema of the extremities, and induration of the skin.

Subcutaneous gas formation is another clue that someone should look for when diagnosing this type of infection. Gas in the tissue is known as crepitus and is known to occur in the presents of aerobic and anaerobic bacteria. According to the data diabetes is one of the main diseases that can develop into a soft tissue infection. Taking certain medications can also put you at risk for necrotizing fasciitis. Necrotizing fasciitis is categorized into three different categories with type two being the most to occur. In critically ill patient’s necrosis of the skin can cause organ failure, and in most cases death.