Necrotising Fasciitis

Question 1

What are the different types of Necrotising fasciitis

Answer 1

1. Polymicrobial (commonly occurs post operatively).
2. Streptococcus pyogens
3. Gas forming organisms eg, c. perfringes

Question 2

Where does Necrotising fasciitis most commonly effect?

Answer 2

Perineum (fournier’s gangrene)

Question 3

Presentation of Necrotising fasciitis?

Answer 3

Acute onset,
Pain, swelling and erythema at affected site (rapidly worsening cellulitis with pain out keep)
Hypoasthesia to light tough.
Skin necrosis and gas gangrene
Fever and tachycardia

Question 4

What is the management of Necrotising fasciitis?

Answer 4

Urgent surgical debridement and IV Abx.
Antibiotics:
Broad spectrum eg, tazocin/meropenem/ceftriaxone/cipro
AND
MSRA cover: Vancomycin
AND
Antitoxin: Clindamycin