Necrotizing soft tissue infection.
BACKGROUND
Necrotizing soft tissue infections (NSTIs) continue to pose major problems in diagnosis and management.


METHODS
Review of the pertinent English-language literature.


RESULTS
A high index of suspicion and good clinical judgment should be used in conjunction with laboratory and imaging studies in appropriate cases to establish the diagnosis as rapidly as possible. Successful treatment requires early, aggressive surgical debridement of all necrotic tissue, appropriate systemic antibiotic therapy, and supportive care to maintain oxygenation and tissue perfusion.


CONCLUSIONS
The mortality rate of necrotizing soft tissue infection remains approximately 25% despite optimal care. Delayed definitive debridement remains the single most important risk factor for death.
Cuschieri
Joseph
J
Department of Surgery, University of Washington, Seattle, Washington, USA. jcuschie@u.washington.edu
D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D003646:Debridement; D006801:Humans; D007262:Infusions, Intravenous; D009026:Mortality; D009336:Necrosis / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D017410:Practice Guidelines as Topic; D018461:Soft Tissue Infections / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*
D000900:Anti-Bacterial Agents