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Abstract : |
PURPOSE: To review all cases of necrotising infection managed in the Department of Orthopaedic Surgery of Dunedin Hospital in New Zealand between 1989 and 1998. METHODS: Hospital records were analysed for predisposing factors, clinical features, diagnostic results, treatment strategies, and outcomes. RESULTS: 13 cases (9 males and 4 females) of necrotising infection were identified. The mean age was 48 years (range, 8-76 years). Presenting symptoms included painful swelling, erythema, and necrosis. Most patients had predisposing factors and had received nonsteroidal anti-inflammatory drugs before presentation. 12 patients underwent surgical debridement including a total of 4 amputations. Septic shock developed in 9 patients who required dialysis for renal failure. Four patients died. The most common organisms identified were group A beta-haemolytic streptococci. CONCLUSION: Severe necrotising infections require a high index of suspicion and rapid medical and surgical intervention to reduce the mortality and morbidity., |
