Surgical management of necrotizing cellulitis: Results of a survey conducted in French plastic surgery departments.
OBJECTIVE
Necrotizing cellulitis (NC) is a severe infection of the skin and soft tissues, requiring an urgent multidisciplinary approach. We aimed to clarify the surgical management of NC in French plastic surgery departments.


METHODS
Thirty-two French plastic surgery departments were invited to complete a survey sent by email. Questions focused on diagnostic and therapeutic management of NC in France.


RESULTS
Twenty-five plastic surgery departments completed the survey (78%) and each center had a lead plastic surgeon. Overall, 88% of surgeons declared to have managed at least five NC patients within the year. The plastic surgeon was the lead surgical specialist for NC in 80% of cases. Conversely, 76% of interviewed facilities reported not to have any lead medical specialist. Time between surgical indication and surgical management was less than six hours in 92% of cases. Overall, 24% of responding facilities declared that access to the operating room never delayed management. Finally, 80% of facilities declared to be in favor of dedicated care pathways to improve the management of necrotizing cellulitis patients.


CONCLUSIONS
Our study results highlight the heterogeneity of necrotizing cellulitis management in France. The lack of a dedicated care pathway may lead to diagnostic and treatment delays.
Université Paris Est, Hôpital Henri-Mondor, Service de chirurgie plastique, reconstructrice et esthétique, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France. Electronic address: j.niddam@yahoo.fr.
J
J
Niddam
Université Paris Est, Hôpital Henri-Mondor, Service de chirurgie plastique, reconstructrice et esthétique, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
R
R
Bosc
Université Paris Est, Hôpital Henri-Mondor, Service de chirurgie plastique, reconstructrice et esthétique, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
B
B
Hersant
Université Paris Est, Hôpital Henri-Mondor, Service de chirurgie plastique, reconstructrice et esthétique, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
J
J
Bouhassira
Université Paris Est, Hôpital Henri-Mondor, Service de chirurgie plastique, reconstructrice et esthétique, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
J-P
JP
Meningaud
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002481:Cellulitis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D003131:Combined Modality Therapy; D019091:Critical Pathways; D003646:Debridement / Q000706:statistics & numerical data*; D057210:Delayed Diagnosis; D019468:Disease Management; D019115:Fasciitis, Necrotizing / Q000209:etiology / Q000601:surgery*; D005602:France; D019538:Health Care Surveys; D006748:Hospital Departments / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D019651:Plastic Surgery Procedures / Q000706:statistics & numerical data*; D013518:Surgery, Plastic / Q000458:organization & administration; D061665:Time-to-Treatment
D000900:Anti-Bacterial Agents
Fasciite nécrosante; Necrotizing cellulitis; Sepsis