Treating necrotising fasciitis
When necrotising fasciitis is suspected, a patient should be put onto intravenous antibiotics without delay. This will kill the bacteria and slow the rate of reproduction. A patient must then be taken to theatre at the earliest opportunity for surgical debridement, as this is the only way to effectively treat the condition.
Surgical debridement is when tissue is surgically removed. It is vital that all of the infected tissue is excised, or the infection will remain in the body and continue to cause problems. More than one operation may be required to achieve this, particularly if there is a large area of necrosis. In some cases an entire limb will need to be amputated.
Recovering from necrotising fasciitis
After surgery, a patient will need constant medical care. Having a large area of tissue removed can send the body into shock, while associated complications such as organ failure may arise. Many will be sent straight to the intensive care unit after the operation, such is the severity of the situation.
With close medical attention, a patient’s condition should gradually stabilise. The wound will need to be kept clean and the dressings changed daily. A patient must also be kept hydrated and continue to take antibiotics. The recovery period may slow, especially if the area of necrotic tissue was widespread.
When a patient is well enough a cosmetic surgeon may be asked to assess the wound. Debridement often leaves a significant defect and skin grafts could help improve the aesthetic appearance.
Necrotising fasciitis complications
Sadly necrotising fasciitis can result in serious, if not fatal, complications. Patients who are frail or who have a compromised immune system may not be able to recover from the infection. Life threatening problems will also occur if the infection is allowed to progress to the advanced stages. This will happen very quickly – usually within four to five days.
If left untreated, the bacteria will rapidly multiply and the area of necrotic tissue will quickly grow. This will be very dangerous as the infection could reach the bloodstream, a condition known as sepsis. This may in turn lead to multi-system organ failure. When treatment is eventually provided all of the necrotic tissue will need to be removed. This can prove too traumatic and the body may begin to shut down.
Necrotising fasciitis and a delay in treatment
If these complications occur because of a delay in treatment, questions must be raised as to why surgical debridement was not performed earlier. If medical error is to blame – for example, because doctors did not make a timely diagnosis – the care provided will be considered substandard. Anyone injured because of an unacceptable level of medical care will be entitled to make a medical negligence claim.