Necrotizing Fasciitis After C Section
A caesarean section would is vulnerable to infection. If an infection does develop in the caesarean section scar, urgent medical attention is needed. This is particularly true if the infection is necrotising fasciitis, an aggressive 'flesh-eating' disease that can leave the patient critically unwell and in need of abdominal reconstruction.
Necrotising fasciitis
Necrotising fasciitis is a bacterial infection of the soft tissues. It can appear anywhere in the body. For the condition to develop the bacteria must be presented with an opportunity to enter the body and travel to the deep tissues. Once in the tissues the bacteria reproduce, a process which releases a toxin and damages the tissues and blood vessels. The tissues will begin to die due to the lack of blood and oxygen – called 'tissue necrosis' in medical terms.
Necrotizing fasciitis after surgery
Necrotising fasciitis can affect anyone, even seemingly healthy individuals. Some cases also appear out of the blue, with the patient not being able to pinpoint a way in which the bacteria got into the body. Sometimes all it takes is for the bacteria to infiltrate through a tiny cut or scratch that is so small the individual is not even conscious of it.
In other cases it is more obvious as to how the bacteria have infected the body, especially if the patient has recently undergone a surgical procedure and the surgical site has become infected. One study suggests that 20% of necrotising fasciitis infections occur post-surgically.
Necrotizing fasciitis after a C-section
Types of abdominal surgery – which includes C-sections – are more prone to surgical site infections because the amount of bacteria in the abdomen. There is also medical evidence to suggest that the use of non-steroidal anti-inflammatory drugs (NSAIDs) can increase the risk of necrotising fasciitis. NSAIDs can be given after a C-section to reduce the pain and inflammation.
If necrotising fasciitis does develop after a caesarean section, the patient will become very unwell. She may no longer be in a hospital setting as the infection can take a few days to appear. When it does arise, she will typically experience a fever and extreme pain around the C-section scar. The scar will be red and hot to touch, and may also be emitting a foul-smelling odour and/or fluid.
Treating necrotising fasciitis after a C-section
These are the characteristic signs of a surgical site infection and should not be ignored by either the patient or medical practitioners. Necrotising fasciitis is rare, but surgical site infections are not uncommon and clinicians should quickly recognise the signs – even if they are at the stage unaware of the disease necrotising fasciitis.
Swabs should be taken of the caesarean section wound and sent to the laboratory for testing. This will confirm the pathogen responsible for the infection, revealing the presence of necrotising fasciitis. In the meantime, the patient should be started on broad-spectrum intravenous antibiotics.
The next step is to take the patient to theatre to remove the dead tissue. This procedure may initially be considered as exploratory surgery, but as soon as the tissue is opened up the surgical team will find presence of tissue necrosis. The procedure can then be changed to debridement surgery, which involves cutting away all the infected tissue.
Complications of necrotizing fasciitis after C section
Necrotizing fasciitis can be fatal and does have a high mortality rate. It can lead to tragic consequences because the infection can trigger a septic response, where the body tries to fight off the bacteria but damages its own tissues and organs in the process. The patient can then develop extremely low blood pressure and organ failure, complications which can be fatal.
Removing a large amount of tissue from the abdomen can also be dangerous, especially if the infection has spread to the abdominal organs. The debridement surgery can send the patient into shock, although surgery is the only way to treat the condition so it must be performed. It will also leave an open wound that can be difficult to close, meaning it will be exposed to further infection. This can lead to potentially fatal complications in itself.
Delayed diagnosis and treatment of necrotizing fasciitis
These complications are more likely to occur if there is a delay in the patient being given treatment. Necrotising fasciitis is a fast-moving infection and it can be just days or even hours before the patient is in a critical condition. Therefore the patient must seek immediate medical attention, and clinicians must diagnose and treat the illness on an emergency basis.
Unfortunately there are times when a patient will develop necrotising fasciitis but by the time they reach hospital it is too late and they are already in a critical condition. Sometimes, however, blame will lie with medical practitioners who fail to recognise and treat the condition within a reasonable amount of time.
As mentioned earlier in this article, necrotizing fasciitis is very rare. Even so, the fact that the patient has a weeping/sore-looking C-section wound should indicate a soft tissue infection. The fact that the patient is rapidly deteriorating with organ failure and septic shock should indicate that it is a very aggressive bacterial infection that requires emergency medical attention.
Failure to spot necrotizing fasciitis after C section
If medical professionals fail to realise that a woman is suffering from necrotising fasciitis in her caesarean section wound, the consequences can be fatal or near-fatal. If a maternal death is avoided, it is likely that the patient will need abdominal reconstruction, leaving extensive scarring and traumatic memories.
If you or your loved one fell seriously ill with necrotising fasciitis after a C-section and you believe care was negligently delayed, please get in touch with us. We specialise in medical negligence claims and have extensive experience in necrotising fasciitis claims. We can help you understand what went wrong and whether anyone is at fault.
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