The diagnosis and management of necrotising fasciitis

INTRODUCTION Necrotising soft tissue infections (NSTIs) were first described in 1871 as ‘hospital gangrene’ and they continue to carry a high mortality and morbidity rate[1]. Necrotising soft tissue infections are, as the name implies, infections that affect the soft tissue by causing necrosis. They spread along the fascial layers and can be either monobacterial or multibacterial in origin. Although they are most often associated with surgical wounds, they can also occur in tiny cracks or breaks in the skin. They are considered surgical wound infections because the treatment involves surgical excision in addition to antibiotic administration, unlike non-necrotising soft tissue infections that require antibiotics only. However, in the years since NSTIs were first discovered, many classifications and terms have been used to describe them and there has been confusion surrounding their diagnosis and management[1–5] This review will focus on the diagnosis, management and outcome of this condition.