European Journal of Molecular & Clinical Medicine

Abstract

Aim: To determine the presentation of patients diagnosed with NSTIs and the inhospital
patient outcomes (including antibiotic treatment, surgery, and mortality)
associated with this disease.
Material and methods: The study was prospective cohort study conducted from
February 2020 to February 2022in patient’s admitted in the department of general
surgery through outpatient department/Emergency/transferred from other
departments.Case of NSTI were included in the study. Viral marker for HBsAg and
HCV were tested prior to surgery and informed consent for HIV testing was taken prior
to HIV test.The patients were underwent debridement on the basis of extension of the
infection. Tetanus vaccine was given to each patient followed by intravenous
prophylactic antibiotics. Local or general anaesthesia was used according to its merit in
each case. Skin was incised mainly till fascia or depending upon the depth of infection,
drainage of pus and debridement of soft tissue.Patients were followed up for 1 month
post-operatively with daily aseptic dressings till healthy granulation tissue appears
followed by soft tissue coverage by flap or grafting and the data was collected as per the
Performa attached and the data collected was tabulated and subjected to the study.
Results: It was seen thatcomorbidities like burns(p value =0.039) and cardiac diseases(p
value=0.043) had statisticallysignificant association with the outcomes.A statistically
significant association was seen among systemic symptoms likehypotension (p value=
0.003), and laboratory investigations like increased creatinine (pvalue=0.002) with the
outcomes.
Conclusion: NSTI is a rare but highly morbid disease entity. Therefore early detection
and aggressivedebridement are the cornerstones of NSTI treatment. Antibiotictherapy
and intensive care support is also essentialin severe cases of NF. A high index of
suspicion and timely surgical intervention, with repeated debridements and early ICU
admission can minimize the morbidity and mortality of necrotizing fasciitis.