It is not always clear what has caused necrotising fasciitis but certain patients are more vulnerable to it and certain hospital procedures may expose the patient to developing infection.
What is necrotising fasciitis?
Necrotising fasciitis is a soft-tissue infection which can spread rapidly through the body destroying tissue and threatening the life of the patient. Even where the patient survives, they are likely to have undergone extensive surgical removal of damaged tissue and will be left with scarring, possible disability and psychological damage.
What causes necrotising fasciitis?
Necrotising fasciitis can be caused by a variety of different bacteria which can be fairly benign outside the body. Once these bacteria reach the subcutaneous tissue inside the body, however, they interact with the internal environment of the patient, releasing toxins and causing the destruction of surrounding tissue. This can lead to multiple organ failure.
Necrotising fasciitis in hospital
Necrotising fasciitis can sometimes arise when a patient is undergoing treatment in hospital. Surgical procedures, injections, wounds and extended bed stays can all offer circumstances which might encourage the development of this appalling illness.
It is also likely that a patient in hospital may already have a weakened immune system or pre-existing condition which makes it harder for their body to fight off the threat of necrotising fasciitis.
Surgery
Surgery, whether open or keyhole, can provide a route for bacteria to enter the body. Necrotising fasciitis occurs most frequently in the abdomen or limbs and so abdominal surgery puts the patient at some risk.
A range of abdominal operations have been associated with the development of this appalling conditions, such as:
- Gallbladder removal (cholecystectomy)
- Hysterectomy
- Caesarean section
- Hernia repair
- Removal of the appendix
- Kidney transplant
- Bowel surgery
It may, therefore, be appropriate for certain, high-risk, patients to be given antibiotics prior to their operation in order to try to reduce the risk of infection. Such patients might include those who suffer with diabetes and/or are overweight, both factors appearing to have some association with a greater susceptibility to necrotising fasciitis.
The current NICE quality statement regarding this issue proposes that ‘Healthcare professionals offer antibiotic prophylaxis to people having surgery for which antibiotic prophylaxis is indicated, in accordance with the local antibiotic formulary and record when this has been given.’
If prophylactic antibiotics are indicated for a patient but are not given, the medical professional responsible may be considered to have been negligent if that patient subsequently develops necrotising fasciitis.
Post-operative observation
It is clear, therefore, that such patients also require close monitoring for and rapid response to any signs of infection or pain following their operation.
If the patient reports extreme pain in the area of their wound and is exhibiting flu-like symptoms such as a high temperature or chills, but action is not taken to investigate such symptoms, the hospital may be considered to have provided a substandard level of medical care.
Pressure sores and necrotising fasciitis
Patients who require extended stays in hospital or who have restricted mobility such as the elderly, are susceptible to the development of pressure sores and this can also offer a chance for necrotising fasciitis to develop.
NICE guidelines regarding the management of patients susceptible to pressure sores in hospital explain the need for risk assessment and appropriate treatment such as regular re-positioning of the patient, possible use of barrier creams and use of a specialist mattress.
Where medical staff fail to properly support, move and monitor patients, allowing pressure sores to develop, they may be considered to have provided substandard medical care, especially if the patient then develops an infection.
Equally, where pressure sores are identified but inadequately monitored or cared for, and the patient subsequently develops necrotising fasciitis due to infection, there may be an issue of medical negligence.
Delayed diagnosis and treatment
Whatever the cause of necrotising fasciitis, prompt diagnosis and treatment are imperative. Any delay may threaten the life of the patient.
Where a patient has been diagnosed with or suspected of having necrotising fasciitis, it is usual for antibiotics to be administered intravenously immediately.
Surgical debridement of all affected tissue as quickly as possible is necessary in order to stop the spread of the infection and save the life of the patient.
Medical Negligence
If you or a loved one have suffered from the shocking effects of necrotising fasciitis, you may be entitled to make a claim for compensation if the medical professionals involved have failed to offer an appropriate level of care.
Contact Glynns Solicitors to discuss your situation. We have supported numerous claims for necrotising fasciitis negligence and would be happy to advise you.
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