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September 5, 2025

eP403 Necrotizing Fasciitis: A Comprehensive Analysis of Cases Treated at Our District General Hospital (February 2020 - December 2024)

Key Points

Survival rate for necrotizing fasciitis was found to be 66.7%, with 33.3% mortality reported within the cohort.
Average diagnostic delays were 22.5 hours, and 79.2% of patients required additional surgical interventions.
The study included 24 confirmed cases, assessing demographics, comorbidities, and surgical management techniques.
Aggressive surgical intervention and broad-spectrum antibiotics are essential for improving outcomes in necrotizing fasciitis.

Abstract

Abstract Aims/Objectives This study evaluates the clinical, diagnostic, surgical, microbiological, and functional outcomes of 24 necrotizing fasciitis cases treated over five years. The objective is to identify critical factors influencing outcomes and propose strategies to improve management and care. Methods A retrospective analysis was conducted on 24 confirmed cases of necrotizing fasciitis. Patient demographics, comorbidities, diagnostic methods, anatomical sites, surgical interventions, microbiological findings, and outcomes were assessed to identify trends and variations in disease presentation and management. Results The cohort had a mean age of 56.6 years, with 58.3% being male. Diagnostic delays averaged 22.5 hours, with some exceeding five days. Comorbidities were universal, with Type 2 Diabetes Mellitus and hypertension most prevalent. Diagnosis relied on clinical examination (29.2%) and imaging (33.3%). Surgical management required an average of 3-4 procedures, with 79.2% needing additional interventions like VAC dressings or grafting. Commonly affected sites included the perineum and scrotum (41.6%). Anaerobes were the most frequently identified organisms (16.7%), with meropenem-based antibiotic regimens used in 41.7% of cases. The survival rate was 66.7%, with 33.3% mortality. Complications were reported in 62.5%, including recurrent abscesses, graft failures, and sepsis. Functional outcomes varied: 16.7% regained independence, while 4.2% were left bedbound. Conclusion Necrotizing fasciitis is a life-threatening condition requiring prompt diagnosis and multidisciplinary care. Aggressive surgical intervention, broad-spectrum antibiotics, and comprehensive documentation are crucial for improving survival and functional outcomes. Standardized treatment protocols and enhanced collaboration can help address the significant morbidity and mortality associated with this condition.

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