NECROTISING FASCITIS PPT

1. NECROTISING
FASCITIS
ABHISHEK BHARTI
Roll no 17005

2. INTRODUCTION
• Rapidly spreading necrotising infection of
subcutaneous tissue & fascia
• Alsoknown as: “flesh-eating” bacteria.
• Infection rapidly destroy the skinand soft tissue
beneath it
• Other names: β-hemolytic streptococcal
gangrene, Meleneyulcer, acute dermal gangrene,
hospital gangrene, and necrotizing cellulitis.

3. Types of NF.
• Type I : apolymicrobial flora
• Type II Group A β-Streptococcus bacteria

4. Transmission of bacteria
• From outside due to penetrating trauma,
surgery
• From inside due to transient bacteremia

5. RISK FACTORS
• Old age
• Diabetes
• Alcoholism
• Immuno-suppression-steroids/HCV
• Severe illnesses:heart, lung, or liverdisease
• Malnourished
• Obesity

6. PATHOPHYSIOLOGY
• Bacteria eat away at tissue between skin and
muscle
• Inflammatory response by immune system
• Bacterial toxins released
• Cytokines impede function of phagocytic cells
• Anaerobes thrive speeding up necrotic process
• Endothelium damaged leading to poor blood
supply
• Poor blood supply inhibits inflammatoy
resopnse & cause hypoxia

7. EARLY CLINICAL FEATURE
• Flu like symptoms that include fever, chills,
nausea, weakness, dizziness, aches
• Skinbecomes tender, warm, red in color, and
start to swell
• Patients mayexperience pain greater than
expected from the appearance of the wound
• Subcutaneous tissue mayalso havea hard feel on
palpation

9. ADVANCE CLINICAL FEATURE
• Cellulitis changes to painful pathognomic grey
blue patch within 36 hrs
• Hard woody induration
• Violacous bullae & necrosis with thin watery
malodorous fluid appear
• Progress to deep ulceration & eschar
formation

10. • High fever with chills ,malaise,tachytardia
• Toxic shock syndrome may occur
• Lesion may become anaesthetic due to
cutaneous nerve damage
• MOST Common site are extremities

13. INVESTIGATION & DIAGNOSIS
• Blood investigation:
TLC,DLC,CPK, elevatedor lowered
creatinine, glucose, CPK, bicarbonate, albumin,
andcalcium levels
• MRI toknowdepth
• BacterialCulture & Drugsensitivity

14. TREATMENT
• Early diagnosis & treatment is vital
• Emergency debridement
• IV antibiotics
• Hyperbaric oxygen therapy for anaerobes
• Morphine drip & patient controlled analgesia
pump