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Description

Martinschek et al reported prognostic factors for patients with necrotizing soft tissue infections (NSTI). These can help to identify a patient who may benefit from more aggressive management. The authors are from the Federal Armed Forces Hospital of Ulm, Germany.


Patient selection: necrotizing soft tissue infection (with or without necrosis of muscle; with systemic progression and need for intensive care)

 

Conditions associated with worse survival:

(1) diabetes mellitus

(2) heart failure

(3) sepsis at presentation

(4) abdominal wall involvement

(5) hemodynamic instability

(6) elevated serum CK

(7) elevated serum lactate

 

Cornerstones of management:

(1) early diagnosis and aggressive therapy

(2) immediate adequate surgical debridement

(3) intravenous antibiotic therapy

(4) intensive care

(5) hyperbaric oxygen, especially with Clostridia infections


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