Is Necrotizing Fasciitis Curable?
Necrotising fasciitis must be treated with a combination of antibiotics and debridement surgery. Without this treatment, necrotising fasciitis cannot be cured.
Curing necrotising fasciitis
To say that necrotising fasciitis can be cured is slightly misleading. The condition can be successfully treated, and if this treatment is given in time, the patient can survive.
However, the bacteria cannot be killed with antibiotics alone, as it can with more minor strep infections such as tonsillitis. Instead, surgery is needed to remove the infected tissue. Removing the bacteria from the body is the only way to stop the infection from spreading.
What happens if surgery is not carried out?
If surgery is not performed, the patient is unlikely to survive. One study quotes a 100% mortality rate if necrotising fasciitis is not treated. It becomes fatal because the infection is very aggressive and will trigger a condition called sepsis.
Sepsis is when the immune system over-reacts to an infection, causing the body to damage its own organs and tissues. This will normally affect people whose health is vulnerable (including the elderly, young and infirm), and people with very aggressive bacterial infections (such as necrotising fasciitis).
Because the organs and tissues have been damaged, the heart will be unable to pump blood around the body properly, resulting in extremely low blood pressure. This is called septic shock and it will leave the vital organs deficient in oxygen. Consequently the organs will begin to fail.
Multi-system organ failure will make a patient critically unwell and he/she will need organ support in the Intensive Care Unit. Even with this support, the patient may not survive.
How to cure necrotising fasciitis
Nevertheless, it is possible to survive necrotising fasciitis. As mentioned above, the key to curing necrotising fasciitis is with the correct treatment – intravenous antibiotics and debridement surgery. It is important that this treatment is provided on an emergency basis. If there is a delay, the patient may already be suffering a septic response by the time treatment is initiated.
Antibiotics work to kill bacteria and prevent them from reproducing (and thus spreading). With necrotising fasciitis the medication needs to be injected straight into the vein (intravenously) so that it reaches the target bacteria faster.
To begin with medical practitioners will administer a broad-spectrum antibiotic that works against a variety of bacteria. Once the exact bacteria causing the illness has been identified through laboratory tests, the type of antibiotic can be refined. Certain antibiotics are more effective against certain bacteria, so determining the precise pathogen is useful.
Along with antibiotics, the patient must be rushed to theatre for surgical debridement. This involves putting the patient under general anaesthetic and cutting away all of the infected tissue. If a large amount of tissue has become infected it will all need to be removed, which will of course leave a gaping wound. The assistance of the plastic surgery team may be required, as skin grafts may be needed to close the wound. Sometimes part of a limb, or the whole limb, will be amputated.
Why is treatment needed on an emergency basis?
As highlighted above, treatment for necrotising fasciitis is an emergency. This is because necrotising fasciitis is a fast-moving bacterial infection. It will not take long for the bacteria to infiltrate the deep tissues, begin to reproduce and spread to a large area of tissue. All this tissue will have to be removed. But if treatment is provided early enough, the patient will be saved from having to undergo extensive debridement or amputation.
Along with preventing extensive tissue death, early treatment will also stop the bacteria from reaching the bloodstream and triggering a septic reaction. This will give the patient a much better chance of survival. Therefore emergency treatment is needed to avoid both short-term complications (sepsis) and long-term complications (amputation and tissue loss).
Delayed diagnosis and treatment of necrotising fasciitis
Despite the urgency with which treatment is needed, there are times when a patient with necrotising fasciitis does not get the immediate care he/she requires. Often this is because medical professionals fail to understand the patient's condition and so do not treat it as necrotising fasciitis.
Necrotising fasciitis is associated with symptoms such as a fever, severe localised tissue pain and red/warm/inflamed skin. These symptoms can be confused for other illnesses such as the flu or cellulitis. If the problem is misdiagnosed, it means the patient will not undergo emergency debridement surgery. The bacteria will be left to reproduce and will spread to a greater area of tissue, and possibly also the bloodstream.
Is a delay in treatment negligent?
Necrotising fasciitis is a rare condition, but even so medical practitioners should recognise the signs of a severe soft tissue infection – even if they have never seen a case of necrotising fasciitis before. This should lead to a diagnosis being made and emergency treatment being carried out. As long as this is achieved within a reasonable amount of time, medical practitioners cannot be said to have acted negligently.
But if there is an unreasonable delay, and this causes the patient's condition to deteriorate, there could be a case of medical negligence. If this has happened to you or your loved one, a solicitor will be able to advise whether or not the standard of care was acceptable or unacceptable. If there is an indication that the care fell below a reasonable standard, there could be grounds for a necrotising fasciitis claim.
Speak to a solicitor
To speak to a solicitor about a potential medical negligence claim for necrotising fasciitis, please get in touch with us at Glynns Solicitors. We specialise in medical negligence claims and have successfully settled a number of necrotising fasciitis claims. We will tell you whether or not you have grounds to pursue legal action, and if so, will work on your behalf to get the compensation you deserve.
Medical negligence claims must be made within three years of the event. Therefore it is important to seek early legal advice, or you may miss your opportunity to make a claim.
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For more information on necrotizing fasciitis medical negligence, please get in touch with us today.
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