title: [Necrotizing fasciitis: study of 17 cases presenting a low mortality rate].
abstract: Necrotizing fasciitis is a hypodermis, muscular fascia then dermis necrotizing infection.
  
  
  OBJECTIVE
  The originality of this study is to present a series of necrotizing fasciitis treated and followed these last five years, and to compare the therapeutic results with those of the literature.
  
  
  METHODS
  We led a retrospective study on the patients treated for necrotizing fasciitis between 2005 and 2009 by bringing together the demographic and clinical data, the bacteriological examinations and the results of management. Follow-up data from these patients during period of study (five years) were notified.
  
  
  RESULTS
  Seventeen patients were treated (11 men and six women). The average age of the patients was 52 years (ranging from 28 to 82 years). Risk factors of necrotizing fasciitis for our patients were: nonsteroidal anti-inflammatory drugs (82.2%), cutaneous wound (76.4%), obesity (29.4%), oto-rhino-laryngologic diseases (23.5%), alcoholic and drug addicts (23.5%), and diabetis (11.7%). The most isolated and responsible germ was Streptococcus pyogenes in 75.5% of cases. Culture of specimens collected before antibiotic treatment showed that the bacterium was sensible to the antibiotics being administered (clindamycin in 70.5% of cases). The surgical management was early done with an average delay of 2.7 days (ranging from 1 to 15 days). We observed a low mortality rate (11.7%). One patient died during the period of follow-up after one year (average follow-up of 2.0 years; 1-3 years).
  
  
  CONCLUSIONS
  Contrary to the data from the literature, this study presents a decrease of the mortality in necrotizing fasciitis with an early treatment and an adequate management. The precocity and the quality of surgical procedures as well as the presence of an underlying disease are determining factors for successful management of necrotizing fasciitis.
authors.affiliation: Service de chirurgie plastique, de la main et des brûlés, CHU de Grenoble, BP 217, 38043 Grenoble cedex 09, France.
authors.forename: K
authors.initials: K
authors.lastname: Kibadi
authors.forename: A
authors.initials: A
authors.lastname: Forli
authors.forename: T
authors.initials: T
authors.lastname: Martin Des Pallieres
authors.forename: G
authors.initials: G
authors.lastname: Debus
authors.forename: F
authors.initials: F
authors.lastname: Moutet
authors.forename: D
authors.initials: D
authors.lastname: Corcella
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002981:Clindamycin / Q000627:therapeutic use*; D003646:Debridement / Q000379:methods; D019115:Fasciitis, Necrotizing / Q000382:microbiology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D012307:Risk Factors; D013297:Streptococcus pyogenes / Q000302:isolation & purification; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002981:Clindamycin