Necrotizing Fasciitis Necrotizing fasciitis is a bacterial infection that attacks the soft tissue and the fascia. It is commonly known as the “flesh-eating bacteria”. The term flesh- eating bacteria is not really the word for the disease, as the bacteria does not actually eat the tissue. It also progresses very quickly, greater risk of developing in immunocompromised patients due to conditions such as diabetes and cancer. As the bacterial can be developed in many ways, after abdominal surgery, tiny scratch, C-section, simple cut, or rash, to even a simple blood draw. To get the bacteria it must be introduced into the body, by either direct contact with a person carrying the bacteria or because that person is carrying the bacteria
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There is separation of the necrotic tissue along the facial planes that causes suppuration to occur. The normal fascia surrounding muscle is thick, it forms a protective barrier for the muscles that fight against overlying necrosis. The progressive disease invade the fascia and myonecrosis of the underlying muscle. “The bacteria is spread through the skin, subcutaneous tissue and fascia added by the release of bacterial toxins and enzymes”. This bacteria include hyaluronidase, collagenase, streptokinase and lipase. Necrosis and thrombosis of the vasculature is a result of the penetration. Laboratory, radiologic and histopathologic testing needs to be ordered to confirm the diagnosis of necrotizing fasciitis. They have several treatments that can be administered, intravenous antibiotics such as penicillin, metronidazole, an aminoglycoside or third generation cephalosporin, piperacillin/tazobactam, vancomycin, and clindamycin. The antibiotics can be changed when culture results are obtained.
Some have to have surgical removal and antibiotics to make the treatment effective. The removal of the infected tissue is always necessary to keep it from spreading. There is also hyperbaric oxygen treatment that helps with tissue destruction, but is not widely available. Sometimes amputation of the affected limb is also necessary. Some treatments require a skin graft. A burn center’s wound clinic has staff that is trained in wounds of this degree and can be utilized.