The importance of early diagnosis and surgical treatment of necrotizing fasciitis.

Necrotizing fasciitis is a severe infection with a mixed bacterial population involving a single tissue plane. It is best diagnosed by the history of minor trauma, extreme toxicity, anesthesia of the skin and roentgenologic evidence of soft tissue gas. Initial treatment consists of antibiotics, intravenously administered fluids, blood transfusions, calcium and general patient support. Surgical procedures include extensive debridement as soon as possible and as needed for continued necrosis, secondary closure and skin grafting. The mortality of this disease has not been altered by antimicrobials. Only early recognition and surgical treatment will improve the prognosis.