TTP8.14 Enhancing Necrotizing Fasciitis Management through Evaluation and the Development of Comprehensive Guidelines to Improve Patient Outcomes

Aims The study was conducted to scrutinise the current approaches for management of necrotising fasciitis (NF) at our centre and aimed to formulate evidence-based guidelines to optimise care, outcomes and reduce mortality. The primary objective was refining diagnosis, early surgical intervention, antibiotics protocol and multidisciplinary approach for comprehensive management. Methods A comprehensive retrospective three-year review on 16 patients, diagnosed with NF was conducted. Data were extracted on the site of infection, multidisciplinary involvement, timing and frequency of surgeries, antibiotic regimen, and outcomes. This analysis provides insight to develop the management guidelines to enhance the quality of care. Results In six (37.5%) patients the infection site was premium. Triple assessment by surgery, anaesthesia and critical care was received by ten (62%) patients and ten patients required intensive care admission, reflecting multidisciplinary collaboration. Inconsistencies was observed in antibiotics, mostly clindamycin and Tazocin were administered, initiated within 5 hours of diagnosis. Ten (62%) had surgical intervention, mostly within 12 hours. Multiple debridement ranging from 1 to 9 were performed in eight (50%) patients. Two patients were referred to plastic surgery. 100% cultures have shown polymicrobial growth. Mortality rate was 20% among those who had surgery. The absence of standardised protocol and variability in management in different trust was highlighted in this study. Conclusion The study highlights the need for standardised, evidence-base guidelines for management of NF. The observed variability in patients care and outcome suggest a multicentre audit, to formulate comprehensive guidelines to manage this life-threatening condition to standardised care and enhance outcomes.