Necrotising fasciitis is a severe infection of the deep tissues. It progresses very rapidly, although a patient may appear well in the early stages.
In this article we explore the different stages of necrotising fasciitis, explaining the symptoms of each stage, what treatment must be provided and what will happen if the condition is not diagnosed early on.
Stages of necrotising fasciitis
Medical experts have broken the progression of necrotising fasciitis down into three distinct stages:
- Stage 1: Tenderness of the skin and tissue, erythema (redness of the skin), swelling and skin that is warm to touch.
- Stage 2: The formation of blisters on the skin.
- Stage 3: Crepitus (crackling sounds under the skin), skin anaesthesia (numbness), and skin necrosis (death) with a dark discoloration of the skin.
Necrotising fasciitis can be caused by different types of bacteria. If the super-antigens formed by the Streptococcus group A bacteria are present, a patient may also have low blood pressure, a high fever and multi-organ failure.
Diagnosing and treating necrotizing fasciitis
Patients can appear systemically well in the early stages, despite the fact that necrotising fasciitis is actually a very severe infection that can cause fatal complications. The patient must be carefully observed over a period of time. Any deterioration in their condition – such as blistering and skin discoloration – should prompt immediate action.
Appropriate antibiotics should be started at the earliest opportunity. As mentioned above, necrotising fasciitis can be caused by different types of organisms. The treatment may differ in each case. It is therefore vital that specimens are sent for urgent microbiological investigation, as this will allow the clinician to better tailor the type of antibiotics administered.
A patient should then undergo immediate debridement of necrotic tissue and drainage of pus. This is the only way to rid the body of infection. Absolutely all of the dead tissue, muscle and skin must be removed, and more than one surgical procedure may be necessary.
Delay in necrotizing fasciitis treatment
It is essential that necrotising fasciitis is diagnosed and treatment in the early stages of the condition. Otherwise the bacteria will create an extensive area of dead tissue, and will spread to the bloodstream, leading to septic shock and organ failure.
These consequences can be fatal. In fact, experts suggest that without appropriate antibiotics and widespread surgical debridement, the mortality rate for necrotising fasciitis approaches 100%.
If there is a delay in treatment due to medical error, the standard of care will be judged unacceptable. This may lead to a medical negligence claim. Contact us to find out more.
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