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VOLUME 12 , ISSUE 1 ( January-June, 2023 ) > List of Articles

REVIEW ARTICLE

Use of an Objective Tool in Management of Necrotizing Fasciitis

Rakshith Mohan, T Tirou Aroul, T Lokesh Kumar

Keywords : LRINEC, MRI, Necrotizing fasciitis

Citation Information : Mohan R, Aroul TT, Kumar TL. Use of an Objective Tool in Management of Necrotizing Fasciitis. 2023; 12 (1):3-6.

DOI: 10.5005/jp-journals-10085-9102

License: CC BY-NC 4.0

Published Online: 20-07-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Necrotizing fasciitis is on the right end of the spectrum with associated high morbidity and mortality. Although the descriptions of this can be dated to the times of Hippocrates, the mortality associated with the disease remained high. Early surgical debridement without any controversy is accepted as the single best prognostic indicator, but due to the masked and overlapped clinical findings relying on the clinical prowess of the treating surgeon is questionable. Due to which we need to have an objective method of assessment, many researchers have assessed the use of various biochemical, imaging, and histopathological investigation, which has been reviewed in the same.

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  1. Singh G, Bharpoda P, Reddy R. Necrotizing fasciitis: a study of 48 cases. Indian J Surg 2015;77(S2):345–350. DOI: 10.1007/s12262-013-0835-2.
  2. de Polavieja MG, Fernández R, Martínez C, Prieto F, García L, Bravo D. [Necrotizing infections of the soft tissues]. Enferm Infecc Microbiol Clin 1996;14(1):16–20. PMID: 8714182.
  3. Bosshardt TL, Henderson VJ, Organ CH Jr. Necrotizing soft-tissue infections. Arch Surg 1996;131(8):846. DOI: 10.1001/archsurg.1996.01430200056011.
  4. Nseir S, Pronnier P, Soubrier S, Onimus T, Saulnier F, Mathieu D, et al. Fatal streptococcal necrotizing fasciitis as a complication of axillary brachial plexus block. Br J Anaesth 2004;92(3):427–429. DOI: 10.1093/bja/aeh065.
  5. Andreasen TJ, Green SD, Childers BJ. Massive infectious soft-tissue injury: diagnosis and management of necrotizing fasciitis and purpura fulminans. Plast Reconstruct Surg 2001;107(4):1025–1034. DOI: 10.1097/00006534-200104010-00019.
  6. Adigun IA, Nasir AA, Aderibigbe AB. Fulminant necrotizing fasciitis following the use of herbal concoction: a case report. J Med Case Rep 2010;4(1):326. DOI: 10.1186/1752-1947-4-326.
  7. Bryant AE. Mandell, Douglas, and Bennett's principles and practice of infectious diseases. 8th ed. Philadelphia (PA): Elsevier 2010.
  8. Wong C-H, Chang H-C, Pasupathy S, Khin L-W, Tan J-L, Low C-O. Necrotizing fasciitis: clinical presentation, microbiology, and determinants of mortality. J Bone Joint Surg Am 2003;85(8): 1454–1460. PMID: 12925624.
  9. Smuszkiewicz P, Trojanowska I, Tomczak H. Late diagnosed necrotizing fasciitis as a cause of multiorgan dysfunction syndrome: a case report. Cases J 2008;1(1):125. DOI: 10.1186/1757-1626-1-125.
  10. Puvanendran R, Huey JCM, Pasupathy S. Necrotizing fasciitis. Can Fam Physician 2009;55(10):981–987. PMID: 19826154; PMCID: PMC2762295.
  11. Green RJ, Dafoe DC, Rajfin TA. Necrotizing fasciitis. Chest 1996;110(1):219–229. DOI: 10.1378/chest.110.1.219.
  12. Hasham S, Matteucci P, Stanley PRW, Hart NB. Necrotising fasciitis. BMJ 2005;330(7495):830–833. DOI: 10.1136/bmj.330.7495.830.
  13. Headley AJ. Necrotizing soft tissue infections: a primary care review. Am Fam Physician 2003;68(2):323–328. PMID: 12892352.
  14. Taviloglu K, Cabioglu N, Cagatay A, Yanar H, Ertekin C, Baspinar I, et al. Idiopathic necrotizing fasciitis: risk factors and strategies for management. Am Surg 2005;71(4):315–320. PMID: 15943405.
  15. Tiu A, Martin R, Vanniasingham P, MacCormick AD, Hill AG. Necrotizing fasciitis: analysis of 48 cases in South Auckland, New Zealand. ANZ J Surg 2005;75(1–2):32–34. DOI: 10.1111/j.1445-2197.2005.03289.x.
  16. Salvador VBDG, Juan MDS, Salisi JA, Consunji RJ. Clinical and microbiological spectrum of necrotizing fasciitis in surgical patients at a Philippine University Medical Centre. Asian J Surg 2010;33(1): 51–58. DOI: 10.1016/S1015-9584(10)60009-7.
  17. Forbes N, Rankin AP. Necrotizing fasciitis and non steroidal anti-inflammatory drugs: a case series and review of the literature. N Z Med J 2001;114(1124):3–6. PMID: 11243676.
  18. Nisbet M, Ansell G, Lang S, Taylor S, Dzendrowskyj P, Holland D. Necrotizing fasciitis: review of 82 cases in South Auckland: necrotizing fasciitis. Intern Med J 2011;41(7):543–548. DOI: 10.1111/j.1445-5994.2009.02137.x.
  19. Zerr DM, Alexander ER, Duchin JS, Koutsky LA, Rubens CE. A case-control study of necrotizing fasciitis during primary varicella. Pediatrics 1999;103(4):783–790. DOI: 10.1542/peds.103.4.783.
  20. Clayton MD, Fowler JE, Sharifi R, Pearl RK. Causes, presentation and survival of fifty-seven patients with necrotizing fasciitis of the male genitalia. Surg Gynecol Obstet 1990;170(1):49–55. PMID: 2294630.
  21. Gürlek A, Fırat C, Öztürk AE, Alaybeyoğlu N, Fariz A, Aslan S. Management of necrotizing fasciitis in diabetic patients. J Diabetes Complications 2007;21(4):265–271. DOI: 10.1016/j.jdiacomp.2006.08.006.
  22. Cheng N-C, Tai H-C, Chang S-C, Chang C-H, Lai H-S. Necrotizing fasciitis in patients with diabetes mellitus: clinical characteristics and risk factors for mortality. BMC Infect Dis 2015;15(1):417. DOI: 10.1186/s12879-015-1144-0.
  23. Iacopi E, Coppelli A, Goretti C, Piaggesi A. Necrotizing fasciitis and the diabetic foot. Int J Low Extrem Wounds 2015;14(4):316–327. DOI: 10.1177/1534734615606534.
  24. Elliott D, Kufera JA, Myers RA. The microbiology of necrotizing soft tissue infections. Am J Surg 2000;179(5):361–366. DOI: 10.1016/s0002-9610(00)00360-3.
  25. Childers BJ, Potyondy LD, Nachreiner R, Rogers FR, Childers ER, Oberg KC, et al. Necrotizing fasciitis: a fourteen-year retrospective study of 163 consecutive patients. Am Surg 2002;68(2):109–116. PMID: 11842952.
  26. Carbonetti F, Carusi V, Guidi M, David V. [Necrotizing fasciitis: a comprehensive review]. Clin Ter 2015;166(2):e132–e139. DOI: 10.7417/CT.2015.1836.
  27. Wojtera M, Cheng H, Fiorini K, Coughlin K, Barton M, Strychowsky JE. Group B streptococcal cellulitis and necrotizing fasciitis in infants: a systematic review. Pediatr Infect Dis J 2018;37(9):e241–e245. DOI: 10.1097/INF.0000000000001931.
  28. Edlich RF, Cross CL, Dahlstrom JJ, Long WB. Modern concepts of the diagnosis and treatment of necrotizing fasciitis. J Emerg Med 2010;39(2):261–265. DOI: 10.1016/j.jemermed.2008.06.024.
  29. Fernando SM, Tran A, Cheng W, Rochwerg B, Kyeremanteng K, Seely AJE, et al. Necrotizing soft tissue infection: diagnostic accuracy of physical examination, imaging, and LRINEC score. Ann Surg 2019;269(1):58–65. DOI: 10.1097/SLA.0000000000002774.
  30. Wong C-H, Khin L-W, Heng K-S, Tan K-C, Low C-O. The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections. Crit Care Med 2004;32(7):1535–1541. DOI: 10.1097/01.ccm.0000129486.35458.7d.
  31. Goh T, Goh LG, Ang CH, Wong CH. Early diagnosis of necrotizing fasciitis: early diagnosis of necrotizing fasciitis. Br J Surg 2014;101(1):e119–e125. DOI: 10.1002/bjs.9371.
  32. Wall DB, Klein SR, Black S, de Virgilio C. A simple model to help distinguish necrotizing fasciitis from nonnecrotizing soft tissue infection 11 No competing interests declared. J Am Coll Surg 2000;191(3):227–231. DOI: 10.1016/s1072-7515(00)00318-5.
  33. Bechar J, Sepehripour S, Hardwicke J, Filobbos G. Laboratory risk indicator for necrotising fasciitis (LRINEC) score for the assessment of early necrotising fasciitis: a systematic review of the literature. Ann R Coll Surg Engl 2017;99(5):341–346. DOI: 10.1308/rcsann.2017.0053.
  34. El-Menyar A, Asim M, Mudali IN, Mekkodathil A, Latifi R, Al-Thani H. The laboratory risk indicator for necrotizing fasciitis (LRINEC) scoring: the diagnostic and potential prognostic role. Scand J Trauma Resusc Emerg Med 2017;25(1):28. DOI: 10.1186/s13049-017-0359-z.
  35. Soitkar A, Akhtar M, Choudhari A, Deshmukh S. Necrotizing fasciitis: diagnostic and prognostic value of laboratory risk indicator for necrotizing fasciitis score. Int Surg J 2019;6(5):1750. DOI: 10.18203/2349-2902.isj20191901.
  36. Abdullah M, McWilliams B, Khan SU. Reliability of the Laboratory Risk Indicator in Necrotising Fasciitis (LRINEC) score. Surgeon 2019;17(5):309–318. DOI: 10.1016/j.surge.2018.08.001.
  37. Hsiao C-T, Chang C-P, Huang T-Y, Chen Y-C, Fann W-C. Prospective validation of the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score for necrotizing fasciitis of the extremities. PLoS One 2020;15(1):e0227748. DOI: 10.1371/journal.pone.0227748.
  38. Liao C-I, Lee Y-K, Su Y-C, Chuang C-H, Wong C-H. Validation of the laboratory risk indicator for necrotizing fasciitis (LRINEC) score for early diagnosis of necrotizing fasciitis. Tzu Chi Med J 2012;24(2):73–76. DOI: 10.1016/j.tcmj.2012.02.009.
  39. Bakleh M, Wold LE, Mandrekar JN, Harmsen WS, Dimashkieh HH, Baddour LM. Correlation of histopathologic findings with clinical outcome in necrotizing fasciitis. Clin Infect Dis 2005;40(3):410–414. DOI: 10.1086/427286.
  40. Gök MC, Turhan Y, Demiroğlu M, Kılıç B, Akkuş M, Özkan K. Radiological assessment in necrotizing fasciitis. Med J Islamic World Acad Sci 2017;25(1):19–21. DOI: 10.5505/ias.2017.11886.
  41. Fugitt JB, Puckett ML, Quigley MM, Kerr SM. Necrotizing fasciitis. Radiographics 2004;24(5):1472–1476. DOI: 10.1148/rg.245035169.
  42. Chaudhry AA, Baker KS, Gould ES, Gupta R. Necrotizing fasciitis and its mimics: what radiologists need to know. Am J Roentgenol 2015;204(1):128–139. DOI: 10.2214/AJR.14.12676.
  43. Hayeri MR, Ziai P, Shehata ML, Teytelboym OM, Huang BK. Soft-tissue infections and their imaging mimics: from cellulitis to necrotizing fasciitis. Radiographics 2016;36(6):1888–1910. DOI: 10.1148/rg.2016160068.
  44. Clark ML, Fisher KL. Sonographic detection of necrotizing fasciitis. J Diagnost Med Sonography 2017;33(4):311–316. DOI: 10.1177/8756479317701412.
  45. Wronski M, Slodkowski M, Cebulski W, Karkocha D, Krasnodebski IW. Necrotizing fasciitis: early sonographic diagnosis. J Clin Ultrasound 2011;39(4):236–239. DOI: 10.1002/jcu.20766.
  46. Yen Z-S, Wang H-P, Ma H-M, Chen S-C, Chen W-J. Ultrasonographic screening of clinically-suspected necrotizing fasciitis. Acad Emerg Med 2002;9(12):1448–1451. DOI: 10.1111/j.1553-2712.2002.tb01619.x.
  47. Parenti GC, Marri C, Calandra G, Morisi C, Zabberoni W. [Necrotizing fasciitis of soft tissues: role of diagnostic imaging and review of the literature]. Radiol Med 2000;99(5):334–339. PMID: 10938701.
  48. Wysoki MG, Santora TA, Shah RM, Friedman AC. Necrotizing fasciitis: CT characteristics. Radiology 1997;203(3):859–863. DOI: 10.1148/radiology.203.3.9169717.
  49. Fayad LM, Carrino JA, Fishman EK. Musculoskeletal infection: role of CT in the emergency department. RadioGraphics 2007;27(6): 1723–1736. DOI: 10.1148/rg.276075033.
  50. Levenson RB, Singh AK, Novelline RA. Fournier gangrene: role of imaging. RadioGraphics 2008;28(2):519–528. DOI: 10.1148/rg.282075048.
  51. Gothner M, Dudda M, Kruppa C, Schildhauer TA, Swol J. Fulminant necrotizing fasciitis of the thigh, following an infection of the sacro-iliac joint in an immunosuppressed, young woman. Orthop Rev (Pavia) 2015;7(3):5825. DOI: 10.4081/or.2015.5825.
  52. Ali SZ, Srinivasan S, Peh WCG. MRI in necrotizing fasciitis of the extremities. BJR 2014;87(1033):20130560. DOI: 10.1259/bjr.20130560.
  53. Kim K-T, Kim YJ, Won Lee J, Kim YJ, Park S-W, Lim MK, et al. Can necrotizing infectious fasciitis be differentiated from nonnecrotizing infectious fasciitis with MR imaging? Radiology 2011;259(3):816–824. DOI: 10.1148/radiol.11101164.
  54. Masood Q, Zainab A, Ali AZE, Ahmed T, Zainab A, Hirani A. Imaging studies to diagnose necrotizing fasciitis: a noninvasive approach for clinician. MOJS 2017;5(3):203–204. DOI: 10.15406/mojs.2017.05.00111. Available from: https://medcraveonline.com/MOJS/imaging-studies-to-diagnose-necrotizing-fasciitis-a-noninvasive-approach-for-clinician.html.
  55. Schmid MR, Kossmann T, Duewell S. Differentiation of necrotizing fasciitis and cellulitis using MR imaging. AJR Am J Roentgenol 1998;170(3):615–620. DOI: 10.2214/ajr.170.3.9490940.
  56. Malghem J, Lecouvet FE, Omoumi P, Maldague BE, Vande Berg BC. Necrotizing fasciitis: contribution and limitations of diagnostic imaging. Joint Bone Spine 2013;80(2):146–154. DOI: 10.1016/j.jbspin.2012.08.009.
  57. Hietbrink F, Bode LG, Riddez L, Leenen LPH, van Dijk MR. Triple diagnostics for early detection of ambivalent necrotizing fasciitis. World J Emerg Surg 2016;11(1):51. DOI: 10.1186/s13017-016-0108-z.
  58. Stamenkovic I, Lew PD. Early recognition of potentially fatal necrotizing fasciitis: the use of frozen-section biopsy. N Engl J Med 1984;310(26):1689–1693. DOI: 10.1056/NEJM198406283102601.
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