Clinical Features of Postoperative Necrotizing Fasciitis

Abstract

Necrotizing fasciitis (NF) is a severe bacterial infectious disease associated with necrosis of the skin or subcutaneous tissue. The prognosis of this disease is poor because of the rapidly progressive necrosis of the tissues followed by sepsis or multiple organ failure. We aimed to elucidate the clinical features of postoperative NF. Of 7 patients with postoperative NF, 6 had undergone colorectal surgery and NF occurred within 7 days after the operation in most of the patients. Four patients were infected with gram-negative rod bacteria and three with MRSA. Most patients had necrosis or rubor of the skin and tenderness. CT findings demonstrated subcutaneous gas in most of them. All patients underwent debridement of the subcutaneous necrotic tissues. The overall mortality rate was 28.5%. Risk factors for mortality in patients with postoperative NF were skin necrosis and the interval between the onset of the disease and debridement. These results indicate that early diagnosis and debridement could improve the outcome of postoperative NF.