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van Stigt SF, de Vries J, Bijker JB, et al. Review of 58 patients with necrotizing fasciitis in the Netherlands. World J Emerg Surg. 2016;11:21doi: 10.1186/s13017-016-0080-7.
van Stigt, S. F., de Vries, J., Bijker, J. B., Mollen, R. M., Hekma, E. J., Lemson, S. M., & Tan, E. C. (2016). Review of 58 patients with necrotizing fasciitis in the Netherlands. World journal of emergency surgery : WJES, 1121. https://doi.org/10.1186/s13017-016-0080-7
van Stigt, Sander F L, et al. "Review of 58 patients with necrotizing fasciitis in the Netherlands." World journal of emergency surgery : WJES vol. 11 (2016): 21. doi: https://doi.org/10.1186/s13017-016-0080-7
van Stigt SF, de Vries J, Bijker JB, Mollen RM, Hekma EJ, Lemson SM, Tan EC. Review of 58 patients with necrotizing fasciitis in the Netherlands. World J Emerg Surg. 2016 May 27;11:21. doi: 10.1186/s13017-016-0080-7. eCollection 2016. PMID: 27239222; PMCID: PMC4884415.
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World J Emerg Surg. 2016 May 27;11:21. doi: 10.1186/s13017-016-0080-7. eCollection 2016.

Review of 58 patients with necrotizing fasciitis in the Netherlands.

World journal of emergency surgery : WJES

Sander F L van Stigt, Janneke de Vries, Jilles B Bijker, Roland M H G Mollen, Edo J Hekma, Susan M Lemson, Edward C T H Tan

Affiliations

  1. Department of Surgery, Traumasurgery Radboud University Medical Center, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands.
  2. Department of Medical Microbiology, Radboud University Medical Center, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands.
  3. Department of Anesthesiology, Gelderse Vallei Hospital, Willy Brandtlaan 10, 6716 RP Ede, The Netherlands.
  4. Department of Surgery, Gelderse Vallei Hospital, Willy Brandtlaan 10, 6716 RP Ede, The Netherlands.
  5. Department of Surgery, Rijnstate Hospital, Wagnerlaan 55, 6815 AD Arnhem, The Netherlands.
  6. Department of Surgery, Slingeland Hospital, Kruisbergseweg 25, 7009 BL Doetinchem, The Netherlands.

PMID: 27239222 PMCID: PMC4884415 DOI: 10.1186/s13017-016-0080-7

Abstract

BACKGROUND: Necrotizing fasciitis is a rare, life threatening soft tissue infection, primarily involving the fascia and subcutaneous tissue. In a large cohort of patients presenting with Necrotizing fasciitis in the Netherlands we analysed all available data to determine the causative pathogens and describe clinical management and outcome.

METHODS: We conducted a retrospective, multicentre cohort study of patients with a necrotizing fasciitis between January 2003 and December 2013 in an university medical hospital and three teaching hospitals in the Netherlands. We only included patients who stayed at the Intensive Care Unit for at least one day.

RESULTS: Fifty-eight patients were included. The mortality rate among those patients was 29.3 %. The central part of the body was affected in 28 patients (48.3 %) and in 21 patients (36.2 %) one of the extremities. Most common comorbidity was cardio vascular diseases in 39.7 %. Thirty-nine patients (67.2 %) were operated within 24 h after presentation. We found a type 1 necrotizing fasciitis in 35 patients (60.3 %) and a type 2 in 23 patients (39.7 %).

CONCLUSIONS: Our study, which is the largest study in Europe, reaffirmed that Necrotizing fasciitis is a life threatening disease with a high mortality. Early diagnosis and adequate treatment are necessary to improve the clinical outcome. Clinical awareness off necrotizing fasciitis remains pivotal.

Keywords: ICU; LRINEC score; Necrotizing fasciitis; Outcome; Soft tissue infections; The Netherlands

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