Perineal Necrotising Fasciitis
Sometimes called the 'flesh-eating disease', Necrotising Fasciitis is an uncommon but serious condition which often materialises in the perineal region. The infection must be treated as soon as possible. If medical professionals fail to make a quick diagnosis, a patient's life will be put at risk.
Necrotising Fasciitis – The Flesh Eating Disease
Necrotising Fasciitis is a bacterial infection which affects the body's soft tissue and underlying fascia. The infection develops when the bacteria enter the body and multiply. As they reproduce, the bacteria release a dangerous toxin which kills the soft tissue, causing it to become necrotic. Because the bacteria multiply rapidly, the infection spreads extremely quickly, meaning a swift diagnosis is vital.
Necrotising Fasciitis can occur anywhere in the body. Usually, there will be some form of trauma to the skin, allowing a point of entry for the bacteria. For example, a surgical wound, an intravenous drip, or even a minor cut.
Nevertheless, Necrotising Fasciitis in the abdomen, groin and perineal area is particularly common. When the infection affects the genital area, it is often referred to as Fournier's Gangrene. This will often occur due to poor management of perianal abscesses, lesions or abscesses of the genitalia and vaginal delivery. While the infection may affect anybody, those with diabetes, liver disease, cancer as most at risk, as are alcoholics and intravenous drug users.
Diagnosing Necrotising Fasciitis of the Perineum
A patient with Necrotising Fasciitis of perineum may at first present with a pain which is disproportionate to their injury. Indeed, there may not even have been a previous incident of trauma at the site of infection. The area may be red and firm to touch, and the skin will gradually become darker in colour. As the infection progresses, the wound may start to weep and have a foul smell.
As Necrotising Fasciitis causes extensive damage in a short space of time, a timely diagnosis is absolutely essential if a patient is to avoid serious harm. A patient's symptoms should, therefore, prompt a medical professional into taking immediate action. A firm diagnosis should be sought via blood tests, tissue culture of the infected area, while CT/MRI scans and ultrasounds can also prove useful.
Treating Perineal Necrotising Fasciitis
Once the infection is found to be present, treatment must be given without delay. Antibiotics should be started immediately to prevent the infection spreading further. Any tissue that has become necrotic must be surgically removed – a procedure known as debridement. It is not uncommon for more than one operation to be carried out. If a large amount of tissue has been excised, a patient will sadly be left with extensive damage, and possibly long-term deformity.
After surgery, the wound remains vulnerable to infection. This is particularly true in cases of debridement to the perineum and surrounding areas, as there is a risk of faecal contamination. Consequently many patients will be fitted with colostomies, while Vacuum Assisted Closure (VAC) will help the wound to heal.
Perineal Necrotising Fasciitis and Medical Negligence
If medical professionals do not recognise the symptoms of Necrotising Fasciitis and a diagnosis is delayed, a patient will face further complications. These can develop in as little as 24 hours, and may include sepsis, renal failure, heart failure and even death. The area of necrotic tissue will also advance extremely quickly, meaning the longer treatment is delayed, the more extensive surgical debridement will be.
If you have had Necrotising Fasciitis in the perineal area and have suffered as a result of a delayed diagnosis, you need to speak to a legal expert. This is because you could have been the victim of a substandard level of care. If so, you will be able to make medical negligence compensation claim for the pain and suffering you have endured.
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