File Download
Links for fulltext
(May Require Subscription)
- Scopus: eid_2-s2.0-61849150391
- PMID: 19197096
- Find via
Supplementary
- Citations:
- Appears in Collections:
Article: A review of necrotising fasciitis in the extremities
Title | A review of necrotising fasciitis in the extremities |
---|---|
Authors | |
Keywords | Clostridium Epidemiology Fasciitis, necrotizing Streptococcus Vibrio |
Issue Date | 2009 |
Publisher | Hong Kong Medical Association. The Journal's web site is located at http://www.hkmj.org/resources/supp.html |
Citation | Hong Kong Medical Journal, 2009, v. 15 n. 1, p. 44-52 How to Cite? |
Abstract | Objective: To review currently available evidence on the epidemiology and methods of management for necrotising fasciitis, with particular reference to Hong Kong. Data sources and study selection: Medline, PubMed, and Cochrane Library searches of local and internationally published English language journals, from 1990 to July 2008 using the terms 'necrotising fasciitis', 'Hong Kong', 'diagnosis', 'epidemiology', 'vibrio', 'streptococci', 'clostridia', and 'management'. Data extraction: All articles involving necrotising fasciitis in Hong Kong were included in the review. Data synthesis: The incidence of necrotising fasciitis in Hong Kong and around the world has been increasing. This rapidly progressive infection is a major cause of concern, due to its high morbidity and mortality. Up to 93% of affected patients at our hospital were admitted to the Intensive Care Unit and many still died from septic complications, such as pneumonia and multi-organ failure. Radical debridements in the form of amputations and disarticulations were considered vital in 46% of the patients. Early recognition and treatment remain the most important factors influencing survival. Yet, early diagnosis of the condition is difficult due to its similarities with many other soft tissue disorders such as cellulitis. Repeated surgical debridement or incisional drainage continues to be essential for the survival of sufferers from necrotising fasciitis. Many authorities have reported that carrying out the first fasciotomy and radical debridement within 24 hours of symptom onset was associated with significantly improved survival, which also emphasises the importance of early diagnosis. Conclusion: Clinicians must adopt a high index of suspicion for necrotising fasciitis. Empirical antibiotics must be started early and repeated physical examinations should be performed, while maintaining a low threshold for tissue biopsy and surgery. The timing of the first fasciotomy and radical debridement within a window of 24 hours from symptom onset is associated with significantly improved survival. |
Persistent Identifier | http://hdl.handle.net/10722/125209 |
ISSN | 2023 Impact Factor: 3.1 2023 SCImago Journal Rankings: 0.261 |
References |
DC Field | Value | Language |
---|---|---|
dc.contributor.author | Cheung, JPY | en_HK |
dc.contributor.author | Fung, B | en_HK |
dc.contributor.author | Tang, WM | en_HK |
dc.contributor.author | Ip, WY | en_HK |
dc.date.accessioned | 2010-10-31T11:17:37Z | - |
dc.date.available | 2010-10-31T11:17:37Z | - |
dc.date.issued | 2009 | en_HK |
dc.identifier.citation | Hong Kong Medical Journal, 2009, v. 15 n. 1, p. 44-52 | en_HK |
dc.identifier.issn | 1024-2708 | en_HK |
dc.identifier.uri | http://hdl.handle.net/10722/125209 | - |
dc.description.abstract | Objective: To review currently available evidence on the epidemiology and methods of management for necrotising fasciitis, with particular reference to Hong Kong. Data sources and study selection: Medline, PubMed, and Cochrane Library searches of local and internationally published English language journals, from 1990 to July 2008 using the terms 'necrotising fasciitis', 'Hong Kong', 'diagnosis', 'epidemiology', 'vibrio', 'streptococci', 'clostridia', and 'management'. Data extraction: All articles involving necrotising fasciitis in Hong Kong were included in the review. Data synthesis: The incidence of necrotising fasciitis in Hong Kong and around the world has been increasing. This rapidly progressive infection is a major cause of concern, due to its high morbidity and mortality. Up to 93% of affected patients at our hospital were admitted to the Intensive Care Unit and many still died from septic complications, such as pneumonia and multi-organ failure. Radical debridements in the form of amputations and disarticulations were considered vital in 46% of the patients. Early recognition and treatment remain the most important factors influencing survival. Yet, early diagnosis of the condition is difficult due to its similarities with many other soft tissue disorders such as cellulitis. Repeated surgical debridement or incisional drainage continues to be essential for the survival of sufferers from necrotising fasciitis. Many authorities have reported that carrying out the first fasciotomy and radical debridement within 24 hours of symptom onset was associated with significantly improved survival, which also emphasises the importance of early diagnosis. Conclusion: Clinicians must adopt a high index of suspicion for necrotising fasciitis. Empirical antibiotics must be started early and repeated physical examinations should be performed, while maintaining a low threshold for tissue biopsy and surgery. The timing of the first fasciotomy and radical debridement within a window of 24 hours from symptom onset is associated with significantly improved survival. | en_HK |
dc.language | eng | en_HK |
dc.publisher | Hong Kong Medical Association. The Journal's web site is located at http://www.hkmj.org/resources/supp.html | en_HK |
dc.relation.ispartof | Hong Kong Medical Journal | en_HK |
dc.rights | Hong Kong Medical Journal. Copyright © Hong Kong Medical Association. | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject | Clostridium | en_HK |
dc.subject | Epidemiology | en_HK |
dc.subject | Fasciitis, necrotizing | en_HK |
dc.subject | Streptococcus | en_HK |
dc.subject | Vibrio | en_HK |
dc.subject.mesh | Aeromonas - pathogenicity | - |
dc.subject.mesh | Fasciitis, Necrotizing - complications - epidemiology - microbiology - therapy | - |
dc.subject.mesh | Gram-Negative Bacterial Infections - complications - epidemiology - microbiology - therapy | - |
dc.subject.mesh | Streptococcal Infections - complications - epidemiology - microbiology - therapy | - |
dc.subject.mesh | Streptococcus pyogenes | - |
dc.title | A review of necrotising fasciitis in the extremities | en_HK |
dc.type | Article | en_HK |
dc.identifier.openurl | http://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1024-2708&volume=15&issue=1&spage=44&epage=52&date=2009&atitle=A+review+of+necrotising+fasciitis+in+the+extremities | - |
dc.identifier.email | Cheung, JPY: jcheung98@hotmail.com | en_HK |
dc.identifier.email | Ip, WY: wyip@hku.hk | en_HK |
dc.identifier.authority | Cheung, JPY=rp01685 | en_HK |
dc.identifier.authority | Ip, WY=rp00401 | en_HK |
dc.description.nature | published_or_final_version | - |
dc.identifier.pmid | 19197096 | - |
dc.identifier.scopus | eid_2-s2.0-61849150391 | en_HK |
dc.identifier.hkuros | 178693 | en_HK |
dc.identifier.hkuros | 212324 | - |
dc.relation.references | http://www.scopus.com/mlt/select.url?eid=2-s2.0-61849150391&selection=ref&src=s&origin=recordpage | en_HK |
dc.identifier.volume | 15 | en_HK |
dc.identifier.issue | 1 | en_HK |
dc.identifier.spage | 44 | en_HK |
dc.identifier.epage | 52 | en_HK |
dc.publisher.place | Hong Kong | en_HK |
dc.identifier.scopusauthorid | Cheung, JPY=24554121300 | en_HK |
dc.identifier.scopusauthorid | Fung, B=7103203800 | en_HK |
dc.identifier.scopusauthorid | Tang, WM=7403430820 | en_HK |
dc.identifier.scopusauthorid | Ip, WY=35549641700 | en_HK |
dc.identifier.issnl | 1024-2708 | - |