Necrotising fasciitis is a severe infection involving the subcutaneous tissue and fascia (connective tissue).
Necrotising fasciitis
Necrotising fasciitis is a type of severe infection of the subcutaneous tissue. It is an unusual and severe soft tissue infection in which bacterial toxins are responsible for liquefaction of subcutaneous fat.
Presentation of necrotising fasciitis
The onset of necrotising fasciitis is deceptive. At first the patient may only complain of a vague pain. Eventually discoloration of the skin will occur, which indicates skin gangrene. This is a late manifestation of necrotising fasciitis and happens when the skin is deprived of its blood supply.
Signs of severe sepsis will subsequently arise, with rapid deterioration as the condition moves from a localised infection of the subcutaneous or muscular tissue, to a bloodstream infection with severe septicaemia and toxaemia.
Necrotising fasciitis mortality rates
Once the infection has spread to the bloodstream the condition has a mortality rate of 30 to 50%.
Without adequate antibiotics and urgent major surgical exploration of the area, followed by surgical debridement of the affected skin, tissue and muscle, the mortality rate is almost 100%.
Diagnosing subcutaneous tissue infections
Severe infections of the subcutaneous tissue and skeletal muscle are not only rare but also notoriously difficult to diagnose. The classification of these conditions is controversial, and confusion is common amongst practitioners.
Because of this, necrotising fasciitis often results in devastating complications. If a patient survives, he/she may be left with a large defect and a poor functional outcome. As mentioned above, a patient may develop fatal complications, with severe sepsis and multi-organ failure.
Necrotising fasciitis medical negligence
Even though subcutaneous tissue infections are difficult to diagnose, a delay in treatment caused by medical error may lead to a medical negligence claim. Indeed, the symptoms of necrotising fasciitis should be enough to prompt medical practitioners to suspect some sort of subcutaneous tissue infection. Immediate investigations should then begin to verify the cause.
If medical practitioners fail to appreciate the significance of a patient’s symptoms, and therefore fail to take urgent steps to diagnose the condition, the level of care will be considered substandard. If a patient suffers injuries because of a substandard level of medical care, the patient (or their family) will be able to pursue legal action in the form of a medical negligence claim.
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