Necrotizing fasciitis must be treated with intravenous antibiotics and debridement surgery. It is not enough to simply provide antibiotics as this will not stop the spread of disease.
Antibiotics for necrotizing fasciitis
If a patient is suspected of having necrotizing fasciitis, he/she should be started on antibiotics straight away. This should be administered intravenously – meaning directly into the vein. It is common to administer broad-spectrum antibiotics to begin with, as it will be effective against a large number of bacteria. Once the precise nature of the bacterial infection has been determined the antibiotic treatment can be refined.
Debridement surgery for necrotizing fasciitis
However, intravenous antibiotics alone will not cure necrotizing fasciitis. Antibiotics will help to target the bacteria, but they will not completely treat necrotizing fasciitis. This is because necrotizing fasciitis is a very aggressive infection that causes tissue gangrene and necrosis. Unless this tissue is removed, the patient will not be free of infection.
Therefore it is not sufficient to simply provide antibiotics for necrotizing fasciitis; debridement surgery is needed as well.
Will surgical debridement cure necrotizing fasciitis?
Surgical debridement is when any dead, gangrenous or infected tissue is surgically removed. As long as all of the infected tissue is debrided, necrotizing fasciitis can be successfully treated. Nevertheless, it is important to cut away absolutely all affected tissue or the infection will remain inside the body.
It is also essential that this debridement surgery is provided without delay. Necrotizing fasciitis is a fast-moving infection that can spread to the blood, resulting in a life-threatening condition called sepsis. It can be just a matter of days from the moment of infection to sepsis.
Delay in debridement surgery for necrotizing fasciitis
If there is a delay in performing debridement surgery, the bacteria will reproduce and infect more tissue. The area of infected tissue will increase the longer treatment is withheld. Shortly there will be an extensive area of dead tissue and the bacteria will have reached the bloodstream. The complications associated with sepsis will follow, including septic shock and multi-system organ failure.
If there is a delay in debridement surgery, questions must be asked about the standard of medical care provided. In some cases the medical care will be excellent – debridement surgery will be given upon an emergency basis, but the necrotizing fasciitis was already advanced when the patient presented. Other times, however, there will be delays in the medical care, often due to a missed diagnosis or lack of urgency.
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