Type

Journal Article

Authors

Deborah Ann McNamara
John Patrick Burke
Hilary Humphreys
Joanne O Gorman
Jacqueline Gemma Solon
Carmel Waldron

Subjects

Medicine & Nursing

Topics
drug users drug use fasciitis necrotizing surgical procedures infectious diseases microbiology intervention early intervention risk factors

Necrotizing fasciitis: The need for urgent surgical intervention and the impact of intravenous drug use. (2013)

Abstract Necrotizing fasciitis (NF) is a relatively rare infection of soft tissues. This study reviewed the epidemiology and pathophysiology of admissions to a tertiary referral hospital over a twelve year period comparing outcomes and findings with international norms and to identify potential areas of change to optimise outcomes. A retrospective review of patients diagnosed with NF from Jan 1st 1999 to Dec 31st 2011 was performed. Patient demographics, risk factors, operative procedures, microbiology results and outcomes were recorded. Comparative analysis was performed. 37 patients were admitted with NF, comprising 30 males and 7 females with a median age of 55 years. The most common site of infection was the perineum (51%). The overall mortality rate was 29% and was significantly associated with age greater than 60 years (p = 0.0018) and the presence of one or more risk factor (p = 0.0046). The number of surgical procedures ranged from one to fifteen with a median length of stay of 35.5 days. There was a significant increase in the number of admissions in 2009-2010 (p < 0.001), coinciding with the emergence of NF in intravenous drug users (IVDU). 43% of patients (n = 16/37) required skin grafting, which was significantly higher in the IVDU group (n = 5/6, p = 0.0232). Necrotizing fasciitis remains a significant life-threatening event. The diversity of causative pathogens emphasises the need for prompt microbiology/infectious diseases consultation. The increased occurrence within the IVDU cohort in this study highlights the need for a heightened level of clinical suspicion in these patients to prompt early surgical intervention.
Collections Ireland -> Royal College of Surgeons in Ireland -> PubMed

Full list of authors on original publication

Deborah Ann McNamara, John Patrick Burke, Hilary Humphreys, Joanne O Gorman, Jacqueline Gemma Solon, Carmel Waldron

Experts in our system

1
Deborah A McNamara
Royal College of Surgeons in Ireland
Total Publications: 17
 
2
Hilary Humphreys
Royal College of Surgeons in Ireland
Total Publications: 142