Necrotising Fasciitis Patient Care
Anyone who has experienced necrotising fasciitis has been extremely unfortunate. It is both rare and potentially fatal. Without treatment, almost 100% of patients will die. Even with treatment, mortality rates are as high as 40%. What care is required?
What is necrotising fasciitis?
Necrotising fasciitis is a life-threatening, fast-acting bacterial infection. Once the relevant bacteria have entered the deep tissue of the body, they destroy all surrounding cells, spreading quickly through the connective tissue of the body.
The problems of necrotising fasciitis
At its early stages, necrotising fasciitis can be difficult to identify due to a variety of reasons:
- Although the bacteria usually enter the body via a wound, sometimes there is no obvious entry site
- The early signs are similar to other infections such as cellulitis
- Non-invasive diagnosis can be inconclusive
Care of the patient
Surgery
The most definite way to diagnose necrotising fasciitis is through surgical investigation of the apparent infection site to assess for tissue death (necrosis).
Likewise, the only way to conclusively remove all dead tissue and prevent further spread of infection is through surgical removal (debridement) of all affected tissue. This may be possible in one surgical procedure but, due to the difficulty of diagnosis and the speed of development of the infection, it is more likely that the patient will require 2- 3 surgical procedures to ensure the body is clear of infection.
In order to produce the best outcome, and potentially save a life, initial debridement of affected tissue should be carried out within 12 hours of the diagnosis of the condition.
Occasionally, it is necessary for a (usually lower) limb to be amputated in order to stop the spread of the infection.
Once the patient is free of the disease, further cosmetic surgery will be necessary to attempt to repair the site of debridement.
Antibiotics
Necrotising fasciitis can be caused by a number of different bacteria and, as a consequence, broad-spectrum antibiotics need to be administered intravenously to try to stop the further spread of the infection.
However, antibiotics alone will not eliminate the infection once it has entered the body.
Functional Support
Having necrotising fasciitis will put the body – the immune system and organs, specifically - under considerable pressure and the patient will need both functional and nutritional support in order to survive whilst treatment is undertaken.
This is likely to involve the administration of fluids and direct feeding into the stomach to reduce all demands on the body.
VAC Therapy
There appears to be an increase in the use of vacuum-assisted closure as a means of producing quick and effective healing of the wounds of debridement. This involves applying a sterile foam sponge in the wound and covering this with a transparent adhesive drape which is then evacuated with a vacuum pump. This has been found to improve the healing process.
Medical Negligence
If you or a loved one have suffered the appalling effects of necrotising fasciitis which you believe could have been avoided with more timely diagnosis and treatment, contact Glynns Solicitors. You may be entitled to make a claim for compensation for substandard medical care.
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