Necrotizing fasciitis: A comprehensive review.

Necrotizing soft-tissue infections (NSTIs) are rare but rapidly progressive, life-threatening bacterial infections with high morbidity and mortality. NSTIs include necrotizing forms of fasciitis, myositis, and cellulitis. This article focuses on necrotizing fasciitis (NF) and discusses NF classifications, clinical features, diagnostic approaches, evidence-based treatments, and nursing interventions.

Experiences of family caregivers the first six months after patient diagnosis of necrotising soft tissue infection: A thematic analysis.

BACKGROUND: Necrotising soft tissue infection, or necrotising fasciitis, is a rapidly progressing disease requiring immediate diagnosis and treatment consisting of antimicrobial therapy, hyperbaric oxygen, debridement surgery and treatment in the intensive care unit. The harrowing illness trajectory affects the family caregivers potentially producing long-term psychological issues. OBJECTIVES: We aimed to explore the experiences and coping strategies of family caregivers during the first six months after patient diagnosis of necrotising soft tissue infection. METHODS: Our study had a prospective, explorative, qualitative design using semi-structured interviews and thematic analysis to understand necrotising soft tissue infection as an intrinsic and instrumental case. Family caregivers (n = 25) were recruited at three university hospitals in Denmark and Sweden. FINDINGS: We identified three chronological themes describing issues of importance to the family caregivers. In the intensive care unit: Coping with illness and intensive care; In the ward: Coping with injury and post-intensive care and At home: Coping with recovery and new home life. CONCLUSION: Challenges facing family caregivers of necrotising soft tissue infections survivors are still under-recognised. Healthcare professionals need to ensure that families and stakeholders throughout the patient trajectory have access to and co-create timely information and care plans to bridge the knowledge gap across care environments and to relieve family responsibility.

Differentiating between red legs and cellulitis and reviewing treatment options.

Red legs (RL) is a chronic inflammatory condition often misdiagnosed as cellulitis. Antibiotic therapy is not required and does not resolve the symptoms. The main causes of RL are chronic dermatological and venous disease, including chronic oedema. Raising awareness of this condition among health professionals could prevent misdiagnosis and unnecessary costly and potentially harmful antibiotic therapy. The aim of this paper is to highlight the differential diagnoses and management of red legs, and the author also includes an example through a case history.

A practitioner's guide to necrotizing fasciitis.

Necrotizing fasciitis (NF) is a severe bacterial infection that attacks subcutaneous fat tissues, superficial fascia, deep fascia, and muscle. NF is a rare condition with a mortality that requires nurse practitioners to be adept at identifying signs and symptoms to prompt a quick diagnosis and treatment.

A special case: treatment of a patient with necrotising fasciitis.

The case study in this article describes the rapid and accurate diagnosis of a critically ill patient with necrotising fasciitis (NF). Full-thickness patchy skin necrosis of the right thigh, buttock and flank was detected on admission. Prompt radical debridement together with aggressive fluid resuscitation and broad-spectrum antibiotic administration was initiated. Case ascertainment was used to evaluate the effectiveness of a debridement and wound treatment regime,using a monofilament debridement product, negative wound pressure treatment and, after the critical period had ended, a bio-cellulose+ polyhexamethylene biguanide (PHMB) dressing, followed by a collagen dressing. NF after open haemorrhoidectomy represents a life-threatening complication to otherwise healthy patients. Accurate diagnosis, prompt critical care and surgical treatment, together with debridement using the monofilament product and effective wound bed preparation, lead to a successful outcome.

Necrotizing fasciitis: a case report of a premature infant with necrotizing enterocolitis.

Necrotizing fasciitis (NF) is a severe infection involving the superficial fascia, subcutaneous tissue, and, occasionally, deeper tissue layers. Usual treatment is with surgical debridement in combination with antibiotics. In review of the literature there is one neonatal report of NF associated with necrotizing enterocolitis. We present a case report of a 25 week gestation infant with necrotizing fasciitis and the complexity of wound and pain management presented for the nursing staff in the neonatal intensive care unit.

A divine encounter.

Nurses have unique opportunities to reach beyond circumstances and into the hearts of patients. By being open and available, we show compassion in a way that fosters respect and trust. In this article, a Christian nurse relays a true experience of providing vital spiritual care to a man dying from necrotizing fasciitis.

Surviving life-threatening illness: keys to optimal nursing care.

Necrotizing fasciitis (NF) is a rare yet life-altering infection. Disfigurement and death ensue without accurate diagnosis and treatment. Educational awareness can assist nurses to advocate for differential diagnosis, immediate treatment, and plan of care. This article examines the experience of a mother with NF, application of Neuman's Systems Model (NSM) to address her healing needs, and nursing practice guided by one's personal worldview. NSM was chosen because it is holistic and concise and can be utilized from a Christian perspective.

Necrotizing fasciitis: early detection may save your patient's limb.

Necrotizing fasciitis (NF) is a rapidly spreading infection affecting the subcutaneous soft tissue. Because of its rapid progression and high mortality, it is essential that the patient is diagnosed and treated early. Over the past century and a half, little has changed in the mortality of this disease. The orthopaedic nurse is in a key position to assist with the early detection and treatment of NF. In the following article, the pathophysiology, early disease detection, diagnostic and treatment challenges, and appropriate nursing interventions will be discussed as it relates to improving the care of the patient with NF.

The nurse's role in managing necrotizing fasciitis.

Necrotizing fasciitis (NF), also known as "flesh-eating disease," is a rapid-acting, potentially deadly infection. This condition is devastating in its ability to spread through the body at an alarming rate. It can be caused by almost any type of injury that introduces microorganisms into the subcutaneous tissues. The initial assessment can be deceptive, so awareness is the key to recognition. This condition often goes unrecognized until it is too late or major disfigurement results. Vital nursing strategies for managing the care of patients with NF include early recognition, accurate assessment, and aggressive treatment.

Necrotising fasciitis.

Necrotising fasciitis is a rare soft tissue infection, primarily involving the superficial fascia and resulting in extensive undermining of the surrounding tissues. The author of this article describes her experience when encountering this distressing condition.

Necrotizing fasciitis in primary care: presentation, risk factors and treatment.

Necrotizing skin infections, although rare, have proven difficult to manage and treat in a wide range of patient groups. The risks of extensive tissue necrosis, systemic sepsis and potentially organ failure make this disease one which health-care professionals must be aware of. Treatment involves rapid debridement and intensive therapy including broad spectrum antibiotics. Appropriate wound care is essential as is a great deal of psychological support for the patient and relatives. This article also highlights some of the risk factors which may pre-dispose a patient to infection.

Topical negative pressure and necrotising fasciitis.

This article highlights the importance of using evidence-based practice to improve wound care and support clinical practice. It appraises the literature on the use of topical negative pressure therapy for the treatment of complex, acute and chronic wounds. In an effort to contribute to the substantial evidence already available in support of this therapy, a clinical example of how effective it was at managing necrotising fasciitis is described.

Anesthetic implications of necrotizing fasciitis.

Necrotizing fasciitis, also known as necrotizing acute soft tissue injury (NASTI), commonly occurs as a consequence of group A streptococcal disease. An estimated 9,400 cases of invasive group A streptococcal disease occur annually in the United States, with 600 cases classified as NASTI. Mortality associated with NASTI is estimated at 20% to 50%. Research indicates that early diagnosis and surgical excision of necrotic tissue is the key to minimalization of morbidity and mortality associated with NASTI. Repeated surgeries typically are required in patients with NASTI, posing unusual anesthetic challenges. This article provides an overview of NASTI and includes preoperative, intraoperative, and postoperative anesthetic considerations.