Clinical and laboratory risk indicator for necrotizing fasciitis score in predicting the outcomes in necrotizing soft tissue infection patients

Authors

  • Madhusoodan Gupta Department of Plastic, Aesthetic and Reconstructive Surgery, Medanta-The Medicity, Gurgaon, Haryana, India
  • Aditya Aggarwal Department of Plastic, Aesthetic and Reconstructive Surgery, Medanta-The Medicity, Gurgaon, Haryana, India
  • Hardeep Singh Department of Plastic, Aesthetic and Reconstructive Surgery, Medanta-The Medicity, Gurgaon, Haryana, India
  • Rakesh K. Khazanchi Department of Plastic, Aesthetic and Reconstructive Surgery, Medanta-The Medicity, Gurgaon, Haryana, India
  • Sanjay Mahendru Department of Plastic, Aesthetic and Reconstructive Surgery, Medanta-The Medicity, Gurgaon, Haryana, India
  • Vimalendu Brajesh Department of Plastic, Aesthetic and Reconstructive Surgery, Medanta-The Medicity, Gurgaon, Haryana, India
  • Sukhdeep Singh Department of Plastic, Aesthetic and Reconstructive Surgery, Medanta-The Medicity, Gurgaon, Haryana, India
  • Arun Jeedi Department of Plastic, Aesthetic and Reconstructive Surgery, Medanta-The Medicity, Gurgaon, Haryana, India
  • Deepti Varshney Department of Pathology, MMG District Hospital, Ghaziabad, Uttar Pradesh, India
  • Vishal K. Biswkarma Department of Aesthetic, Plastic and Reconstructive Surgery, Max Super Speciality Hospital, Patparganj, New Delhi, India

DOI:

https://doi.org/10.18203/2349-2902.isj20202395

Keywords:

LRINEC score, Necrotizing fasciitis, NSTI

Abstract

Background: Necrotizing soft tissue infection (NSTI) is a serious condition that can be diagnosed on a high index of suspicion and require urgent surgical treatment. NSTI involved epidermis and dermis but more frequently it affects the deeper layer of adipose tissue, fascia, and muscle. NSTI diagnosis and its treatment include emergent surgical intervention and the use of appropriate antibiotics. In this study, we have been evaluated the laboratory risk indicator for necrotizing fasciitis (LRINEC) score in predicting the outcomes in patients of NSTI.

Methods: We have conducted a prospective study of 36 patients with NSTI. The LRINEC score, predisposing factors, etiology, risk factors, causative microbiological organisms have been studied.

Results: LRINEC score >8 is associated with NSTI in all cases. The mortality and morbidity, length of stay including ICU stay increases with an increase in LRINEC score. The most common microorganism was found to be E. coli followed by Klebsiella.

Conclusions: Although, we used the emergent and liberal debridement and appropriate antibiotic and resuscitation. In this study, morbidity, mortality, and length of hospital stay all are increased with respect to the increase in LRINEC score.

Author Biographies

Madhusoodan Gupta, Department of Plastic, Aesthetic and Reconstructive Surgery, Medanta-The Medicity, Gurgaon, Haryana, India

Department of Aesthetic, Plastic and Reconstructive Surgery

DNB Resident

Aditya Aggarwal, Department of Plastic, Aesthetic and Reconstructive Surgery, Medanta-The Medicity, Gurgaon, Haryana, India

Department of Aesthetic, Plastic and Reconstructive Surgery 

Director

Hardeep Singh, Department of Plastic, Aesthetic and Reconstructive Surgery, Medanta-The Medicity, Gurgaon, Haryana, India

Department of Aesthetic, Plastic and Reconstructive Surgery

Consultant

Rakesh K. Khazanchi, Department of Plastic, Aesthetic and Reconstructive Surgery, Medanta-The Medicity, Gurgaon, Haryana, India

Department of Aesthetic, Plastic and Reconstructive Surgery

Chairman

Sanjay Mahendru, Department of Plastic, Aesthetic and Reconstructive Surgery, Medanta-The Medicity, Gurgaon, Haryana, India

Department of Aesthetic, Plastic and Reconstructive Surgery 

Associate Director

Vimalendu Brajesh, Department of Plastic, Aesthetic and Reconstructive Surgery, Medanta-The Medicity, Gurgaon, Haryana, India

Department of Aesthetic, Plastic and Reconstructive Surgery 

Senior consultant

Sukhdeep Singh, Department of Plastic, Aesthetic and Reconstructive Surgery, Medanta-The Medicity, Gurgaon, Haryana, India

Department of Aesthetic, Plastic and Reconstructive Surgery

Consultant

Arun Jeedi, Department of Plastic, Aesthetic and Reconstructive Surgery, Medanta-The Medicity, Gurgaon, Haryana, India

Department of Aesthetic, Plastic and Reconstructive Surgery

DNB Resident

Deepti Varshney, Department of Pathology, MMG District Hospital, Ghaziabad, Uttar Pradesh, India

Department Pathology 

Consultant Pathologist

Vishal K. Biswkarma, Department of Aesthetic, Plastic and Reconstructive Surgery, Max Super Speciality Hospital, Patparganj, New Delhi, India

Department of Aesthetic, Plastic and Reconstructive Surgery 

Clinical research Coordinator

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Published

2020-05-26

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Original Research Articles