J Korean Burn Soc.  2019 Dec;22(2):66-70. 10.0000/jkbs.2019.22.2.66.

The Clinical Investigation of Necrotizing Fasciitis in Burn Center

• Kim E
• Chun JW
• Kim YM
• Yoon JC
• Lim HJ
• Cho YS
• Kim D
• Hur J
• Chun W

• KMID: 2469252
• DOI: http://doi.org/10.0000/jkbs.2019.22.2.66

Abstract

PURPOSE
The necrotizing fasciitis is a terrifying infectious disease that can rapidly spreads to surrounding tissues when fascia is infected and it can cause sepsis to death if not properly diagnosed and treated. The purpose of this study is to investigate the characteristics, causes, and treatment methods of necrotizing fasciitis in Korea through reviewing patients admitted to our burn center.
METHODS
21 patients with necrotizing fasciitis were selected for this study among those inpatients with electronic medical records (EMR) admitted to Hallym University Hangang Sacred Heart Medical Center from Jan 1, 2008 to June 30, 2019. The medical records and wound photos of those 21 selected subjects were reviewed.
RESULTS
There were 13 male and 8 female patients and mean age was 58.76 years old. 13 of 21 subjects were survived and 8 died (38% mortality rate). The surgical treatments performed were I&D, fasciotomy, debridement, allograft, burring, STSG, flap, and amputation. The most common causes were burns in 9 subjects (6 contact burns) and cellulitis occurred on skins in 5 subjects. And other various causes were observed as fournier's gangrene, stab wound, intramuscular injection, tumor and bleu toe syndrome (toe necrosis). The infected areas were 11 feet and legs, 7 hips, 3 abdomen and trunk in 21 subjects. Of the 8 deaths, 3 were infected in feet and legs, 2 were infected in hips, and 2 were infected in abdomen and trunk. As for underlying diseases, 12 patients with hypertension or diabetes were the highest and others such as cancer and stroke were found.
CONCLUSION
The only method to increase the survival rate is to "˜suspect' the disease as much as possible and perform early extensive excision. It is advisable to treat the disease by the burn center to properly provide adequate and optimal wound management, infection control, medical care and nutritional supports.

Keyword

Necrotizing fasciitis; Burn center; High mortality

MeSH Terms

Abdomen
Allografts
Amputation
Burn Units*
Burns*
Cellulitis
Communicable Diseases
Debridement
Electronic Health Records
Fascia
Fasciitis, Necrotizing*
Female
Foot
Fournier Gangrene
Heart
Hip
Humans
Hypertension
Infection Control
Injections, Intramuscular
Inpatients
Korea
Leg
Male
Medical Records
Methods
Mortality
Nutritional Support
Sepsis
Skin
Stroke
Survival Rate
Toes
Wounds and Injuries
Wounds, Stab