@article{MRA, author = {Huseyin Ulukaya and Sabri Ozturk and Murat Cerikan and Saruhan Mahmutoglu and Kamuran Sevim}, title = { Treatment and Reconstruction in Necrotizing Fasciitis: Our Clinical Approach}, journal = {Medical Research Archives}, volume = {12}, number = {7}, year = {2024}, keywords = {}, abstract = {Background: Necrotizing fasciitis is a rare but serious soft tissue infection that is often life-threatening. This infection is caused by various bacteria and spreads rapidly into deeper tissues. It usually starts with a small wound or cut in the skin and can progress very rapidly, leading to extensive tissue destruction, systemic toxicity and ultimately very high mortality rates. Aims: This article will focus on the strategies we apply in clinical practice to prevent and manage necrotizing fasciitis. Methods: Patients admitted to our clinic between January 2014 and December 2023 were retrospectively reviewed. Individuals whose initial diagnosis and treatment were from an external center and those with a follow-up period of less than six months after treatment were excluded from the study. This article included 127 patients. They were evaluated in terms of epidemiology, demographic characteristics, treatment timing, reconstruction options, return to daily life and complications. Results: Necrotizing fasciitis was observed in the perineum in 92 cases, in the lower extremities in 22 cases, in the upper extremities in 7 cases and in the inguinal region in 6 cases out of 127 patients. The average laboratory risk indicator for necrotising fasciitis (LRINEC) score was 6.7. All patients underwent debridement after diagnosis. Reconstruction was not started until the LRINEC score was below 4 and culture negativity was achieved. As a reconstruction method, skin graft was used in 48 patients, local fasciocutaneous flap in 29 patients, medial circumflex femoral artery flap in 27 patients, free anterolateral thigh flap in 7 patients, singapore flap in 6 patients, scrotal advancement flap in 6 patients and pedicled anterolateral thigh flap in 4 patients. Partial flap loss occurred in 4 patients and surgical site infection occurred in 21 patients. There were no major complications. After reconstruction, the mean time to return to daily life was 14.3 days. Conclusion: These results show that the need for surgical intervention in the treatment of necrotizing fasciitis varies according to the site of infection and the type of microorganism. Demographic factors had no significant effect on the number of surgical debridements. These findings may provide important clues to guide clinical practice and optimize treatment protocols.}, issn = {2375-1924}, doi = {10.18103/mra.v12i7.5464}, url = {https://esmed.org/MRA/mra/article/view/5464} }