Necrotizing fascitis is a specific clinical infection, which is relatively rare. Early recognition of rapidly spreading infection is imperative for cure. The high mortality attendants need aggressive therapy including frequent examination, wide debridement, systemic triple antibiotic: therapy, aggressive wound care, resolving of associated diseases and hyperalimentation. Radical,
excisional debridement and triple antibiotic therapy should be begun as soon as N.F. was confirmed. Experience with 15 patients at Severance Hospital during the past 10 years, between 1974 and 1984, stimulated a review and re-evaluation of this extremely serious type of infection, Results are as follows,
1) The majority of the lesion occurred in 41-50 year of age.
2) The major causes of necrotizing fascitis were perianal abscess (5 cases, 33%) and trauma (3 cases, 20%).
3) Among 15 cases, 12 cases(80%) were diffuse spreading type, and 3 cases(20%) were localized type,
4) The 7 cases(47%) had an associated disease, which were; diabetes mellitus(3 cases, 20%), cervix cancer(2 cases, 13%), hypertension with chronic alcoholism(1 case, 7%), and pulmonary tuberculosis(1 case, 7%). Among 3 patients with diabetes mellitus. 2 patients were died.
5) The organisms grew in 12 out of 15 cases when cultured and there were 14 different-organisms which were cultured in necrotic tissue. Anaerobic bacteria grew in 6 cases(40%), and the majority were bacteroides.
6) The surgical procedures used were; Radical excisional debridement(12 cases, 80%), and I&D(3 cases, 20%). In 10 cases, triple antibiotic therapy was used, and in 5 cases, broad spectrum antibiotics for gram positive and gram negative organisms.
7) The mortality rate was 20%(3 cases).
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