title: Multidisciplinary management of periocular necrotising fasciitis: a series of 11 patients.
abstract: BACKGROUND
  Necrotising fasciitis is an uncommon but life-threatening soft tissue infection characterised by rapidly spreading inflammation and necrosis of skin, subcutaneous fat and fascia. Left untreated, the mortality can be more than 70%. Early surgical intervention can reduce morbidity and mortality.
  
  
  METHODS
  This is a series of 11 patients who presented to our oculoplastic and orbit unit with periocular necrotising fasciitis over a period of five years. We present the modes of presentation, predisposing factors, diagnosis, and the multidisciplinary team management of these patients.
  
  
  RESULTS
  Of the 11 patients, 1 patient died and 2 patients required intensive care management. Of the 10 surviving patients, 8 patients needed further surgical interventions for correction of complications, like eyelid malposition, ptosis and protective or corrective surgery in the form of ectropion correction, skin grafting and other rehabilitative procedures.
  
  
  CONCLUSIONS
  To the best of our knowledge, this is the largest series of periocular necrotising fasciitis in the literature. Necrotising fasciitis is a potentially fatal condition, resulting in a high rate of mortality and morbidity. Early surgical intervention reduces the mortality. A high index of suspicion is needed to make a prompt diagnosis. These patients need expeditious intervention and may require a long follow-up and subsequent surgery for complications related to scarring and other sequelae.
authors.affiliation: Department of Ophthalmology, University Hospitals of Leicester, Leicester, UK. katya.tambe@gmail.com
authors.forename: K
authors.initials: K
authors.lastname: Tambe
authors.forename: A
authors.initials: A
authors.lastname: Tripathi
authors.forename: J
authors.initials: J
authors.lastname: Burns
authors.forename: R
authors.initials: R
authors.lastname: Sampath
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003646:Debridement; D005141:Eyelid Diseases / Q000382:microbiology / Q000601:surgery*; D019115:Fasciitis, Necrotizing / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery; D018461:Soft Tissue Infections / Q000382:microbiology / Q000601:surgery*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents