necrotising fascitis

Question 1

classification of necrotising fascitis ?

Answer 1

type 1 - mixed anaaerobes and aerobes - most commonly occurs post surgery and diabetics = most common

type 2 - caused by strep pyogenes

Question 2

risk factors for necrotising fasciis ?

Answer 2

recent trauma
burns

diabetes mellitus
- particularly treated with SGLT 2

IV drug use

immunosuppression

Question 3

most commonly affected site ?

Answer 3

perineum - fourneir gangrene

Question 4

features of necrotising fascitis ?

Answer 4

acute
pain and swelling at affected sit - out keeping with the cellultiis
extremey tender

m,ay represemnt as bullae , dusky , purpulish discolouration

skin necrosis - crepitus , gas gangrene

fever , tacycardia

Question 5

nvestigation ?

Answer 5

increased lactate annd CK and WBC

XRAY CT MRI 0 show gas

Question 6

management of necrotising fasciitis ?

Answer 6

urgent surgical debridement

IV abx - carbapenem and clindamycin +- MRSA cover

PLASTIC SURGEONS