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Necrotizing Fasciitis

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Musculoskeletal Infections

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Abstract

Necrotizing fasciitis is a severe soft tissue infection that can rapidly progress to sepsis, multi-organ failure and death. It can be the result of a minor penetrating trauma that allows direct bacterial access to the subcutaneous tissue and deep fascia, or it can also occur at the site of a nonpenetrating trauma, such as a muscle strain. Multiple risk factors have been identified, including diabetes mellitus, peripheral vascular disease, and chronic steroid use, but necrotizing fasciitis can also occur in otherwise healthy individuals. Infections can be polymicrobial (Type 1) or monomicrobial (Type 2), which are mainly secondary to group A beta-hemolytic Streptococcus species. Prompt diagnosis utilizing patient history, physical examination, laboratory values and imaging is vital in the treatment of necrotizing fasciitis. Extensive and wide surgical debridement of all necrotic tissue and intravenous antibiotic therapy are the mainstays of treatment. Other adjunctive therapies, such as hyperbaric oxygen treatment, have been reported but require further study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Division of Orthopedic Trauma, Virginia Commonwealth University, Richmond, VA, USA

    Paul W. Perdue Jr.

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  1. Paul W. Perdue Jr.
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Correspondence to Paul W. Perdue Jr. .

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Editors and Affiliations

  1. Division of Infectious Diseases, Virginia Commonwealth University, Richmond, VA, USA

    Julie Reznicek

  2. Department of Orthopaedic Surgery, Division of Orthopedic Trauma, Virginia Commonwealth University, Richmond, VA, USA

    Paul W. Perdue, Jr.

  3. Division of Infectious Diseases, Virginia Commonwealth University, Richmond, VA, USA

    Gonzalo Bearman

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Perdue, P.W. (2020). Necrotizing Fasciitis. In: Reznicek, J., Perdue, Jr., P., Bearman, G. (eds) Musculoskeletal Infections. Springer, Cham. https://doi.org/10.1007/978-3-030-41150-3_17

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  • DOI: https://doi.org/10.1007/978-3-030-41150-3_17

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-41149-7

  • Online ISBN: 978-3-030-41150-3

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