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Necrotising fasciitis

Fasciitis necroticans · Nekrotizující fasciitida

What it is

A bacterial infection racing along the fascia beneath the skin, killing tissue faster than it looks from outside; about one in five dies even with treatment, and every hour's delay to surgery counts.

Symptoms & signs

  • Pain far worse than the redness looks
  • swelling spreading within hours
  • dusky or purple skin, blisters
  • numb skin, crackling under it
  • fever, rapid pulse, falling blood pressure

🚩 Get help if…

  • call 112 / 911 now Pain far worse than the wound or redness looks
  • call 112 / 911 now Skin turning purple, grey or black, blisters or crackling
  • call 112 / 911 now Fever, confusion or a racing heart with a painful wound
  • see a doctor soon Redness spreading fast over hours

Where it strikes

Medical treatment

  • Urgent surgical exploration and removal of dead tissue, repeated every day or two trials support
  • broad-spectrum antibiotics with clindamycin to cut toxin production
  • intensive care for shock
  • LRINEC blood score — misses many cases; must not delay surgery
  • Intravenous immunoglobulin — no gain in the INSTINCT trial not confirmed in trials
  • reconstruction and skin grafts later

Natural & lifestyle

  • Blood-sugar control in diabetes
  • prompt care of wounds

Emerging & experimental

  • Reltecimod (a toxin-blocking peptide) — its phase 3 trial missed its main goal
  • faster imaging and bedside markers

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Hyperbaric oxygen — observational studies disagree; must never delay surgery mixed evidence
  • Honey dressings on the wound after debridement — small wound-care studies early / small studies

ICD codes