Explore the Management Strategies of Managing the Patients with Necrotising Fasciitis: Necrotizing Fasciitis (NF) Essay, NUS, Singapore

Question: The assignment should include a discussion on Necrotising Fasciitis. Through critical discussion and presentation, explore the management strategies of managing the patients with Necrotising Fasciitis. Include relevant evidence-based literature in the assignment.

Case Scenario: 

A 62-year-old Chinese male with a 7-year duration of type 2 diabetes and hypertension presented to the emergency department with fever, pain, swelling, and discolouration of left feet of one-week duration after fishing at east coast park.

On physical examination, the patient was drowsy and confused. His pulse rate was 120 bpm, blood pressure was 80/40 mmHg, respiratory rate was 26 breaths/min and the temperature was 38 degrees Celcius. There was local warmth with erythema and tenderness over his left leg and grossly indurated with blisters. His LRINEC score was 8.

The patient’s blood culture was tested positive for V. Vulnificus. He then underwent emergent left leg debridement and fasciotomy for suspected Necrotising fasciitis. Multiple wound debridement was also done over the next three months for him. The patient was also started on empirical intravenous antibiotics consisting of Piperacillin-Tazobactam, Clindamycin, and linezolid.

Summary:

• Necrotizing fasciitis (NF) is a rare but life-threatening condition, with a high mortality rate
• Early recognition and intervention are important to reduce morbidity and mortality
• LRINEC  is a diagnostic tool used to distinguish Necrotising Fasciitis
• Postoperative management of surgical wound is pivotal, along with proper nutrition of the patient in order to promote wound healing
• Rehabilitation helps to improve the overall quality of life involving physical, emotional, and social well being