title: [Necrotizing fasciitis: results of a survey on management practices in French-speaking intensive care units].
abstract: OBJECTIVE
  Necrotizing fasciitis (NF) are rare and severe soft tissue infections associated with a high mortality rate. In order to assess the management of NF in French-speaking intensive care units (ICUs), we conducted a survey endorsed by the French Society of Anesthesia and Intensive Care (SFAR).
  
  
  METHODS
  Online self-administered survey.
  
  
  METHODS
  A link to an online survey was sent by email to 4620 anesthesiologists and/or intensivists and was available online from January to February 2014.
  
  
  RESULTS
  One hundred and seventy-five physicians (3.8%) who worked in 135 ICUs filled out the online survey. Among respondents, 42% reported having managed up to two patients with NF during the previous year; 59% and 72% of respondents reported not having a surgical and a medical specialist consultant, respectively. A delayed access to the operating room (OR) of more than 6hours was reported in 31% of cases and access to the OR was reported not to be routinely considered as a priority in 13% of cases. Only 17% of respondents reported that time to transfer to the OR was never a cause for delayed surgery. The main causes for delayed surgery were: delayed diagnosis (45%), delayed validation of surgical intervention (37%), and difficulty of access to the OR (8%). Finally, 83% of respondents estimated that creating dedicated multidisciplinary teams for managing NFs could lead to improving outcomes.
  
  
  CONCLUSIONS
  This survey illustrates the heterogeneous management of NF in French-speaking ICUs and points out several logistical aspects that should be improved to reduce the time to the first surgical debridement.
authors.affiliation: DHU A-TVB, service de réanimation médicale, CARMAS research group, hôpitaux universitaires Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France; UPEC-université Paris-Est Créteil-Val-de-Marne, Créteil, France. Electronic address: nicolas.de-prost@hmn.aphp.fr.
authors.forename: N
authors.initials: N
authors.lastname: de Prost
authors.affiliation: UPEC-université Paris-Est Créteil-Val-de-Marne, Créteil, France; Service de chirurgie plastique, hôpitaux universitaires Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
authors.forename: R
authors.initials: R
authors.lastname: Bosc
authors.affiliation: DHU A-TVB, service de réanimation médicale, CARMAS research group, hôpitaux universitaires Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France; UPEC-université Paris-Est Créteil-Val-de-Marne, Créteil, France.
authors.forename: C
authors.initials: C
authors.lastname: Brun-Buisson
authors.affiliation: UPEC-université Paris-Est Créteil-Val-de-Marne, Créteil, France; Service de dermatologie, hôpitaux universitaires Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France; Satellite français du Cochrane Skin Group, Inserm, centre d'investigation clinique 006, Créteil, France.
authors.forename: O
authors.initials: O
authors.lastname: Chosidow
authors.affiliation: UPEC-université Paris-Est Créteil-Val-de-Marne, Créteil, France; Département de virologie, bactériologie, hygiène, parasitologie, mycologie, hôpitaux universitaires Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
authors.forename: J-W
authors.initials: JW
authors.lastname: Decousser
authors.affiliation: UPEC-université Paris-Est Créteil-Val-de-Marne, Créteil, France; Service d'anesthésie et des réanimations chirurgicales, hôpitaux universitaires Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
authors.forename: G
authors.initials: G
authors.lastname: Dhonneur
authors.affiliation: UPEC-université Paris-Est Créteil-Val-de-Marne, Créteil, France; Département de virologie, bactériologie, hygiène, parasitologie, mycologie, hôpitaux universitaires Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
authors.forename: R
authors.initials: R
authors.lastname: Lepeule
authors.affiliation: UPEC-université Paris-Est Créteil-Val-de-Marne, Créteil, France; Service d'imagerie médicale, hôpitaux universitaires Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
authors.forename: A
authors.initials: A
authors.lastname: Rahmouni
authors.affiliation: UPEC-université Paris-Est Créteil-Val-de-Marne, Créteil, France; Service de dermatologie, hôpitaux universitaires Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
authors.forename: E
authors.initials: E
authors.lastname: Sbidian
authors.affiliation: UPEC-université Paris-Est Créteil-Val-de-Marne, Créteil, France; Service d'anesthésie et des réanimations chirurgicales, hôpitaux universitaires Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
authors.forename: R
authors.initials: R
authors.lastname: Amathieu
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003422:Critical Care / Q000379:methods*; D057210:Delayed Diagnosis; D019115:Fasciitis, Necrotizing / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D005602:France; D019538:Health Care Surveys; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D061665:Time-to-Treatment
chemical_list: D000900:Anti-Bacterial Agents
keywords: Cellulite; Cellulitis; Fasciite nécrosante; Infection de la peau et des parties molles; Necrotizing fasciitis; Sepsis; Skin and soft tissue infections