RT Book, Section
A1 Urbina, Tomas
A1 Prost, Nicolas de
A2 Schmidt, Gregory A.
A2 Kress, John P.
A2 Douglas, Ivor S.
SR Print(0)
ID 1201806178
T1 Necrotizing Soft Tissue Infections
T2 Hall, Schmidt and Wood’s Principles of Critical Care, 5<sup>th</sup> Edition
YR 2023
FD 2023
PB McGraw Hill
PP New York, NY
SN 9781264264353
LK accesssurgery.mhmedical.com/content.aspx?aid=1201806178
RD 2024/10/09
AB KEY  POINTSNecrotizing  soft  tissue  infections  (NSTIs)  are  life-threatening  soft  tissue  infections  defined  by  a  necrotizing  component  involving  any  or  all  the  layers  of  the  soft  tissue  compartment.NSTIs  of  the  extremities,  mainly  of  the  lower  limb,  represent  the  most  common  condition.Most  NSTIs  involve  polymicrobial  pathogens;  In  20%  to  30%  of  cases,  NSTIs  are  monomicrobials  and  primarily  involve  Group  A  streptococcus  (GAS).The  “gold  standard”  to  confirm  the  diagnosis  of  NSTI  is  surgical  exploration.In  patients  with  sepsis  or  septic  shock,  imaging  (CT  scan  and/or  MRI)  must  never  delay  surgery.The  key  early  therapeutic  interventions  required  are  broad-spectrum  antibiotics  and  debridement  surgery.The  mainstem  of  empiric  treatment  is  a  broad-spectrum  beta-lactam  with  additional  aminoglycosides  in  case  of  septic  shock.  Clindamycin  should  be  added  in  case  of  documented  or  suspected  (GAS)  infection.