ArticleAnnals of the Royal College of Surgeons of England2015
Necrotising soft tissue infection in a UK metropolitan population.
Article in Annals of the Royal College of Surgeons of England, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
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35 citing papers in PubMed, 1 synthesis or guideline pooled it, 75 citations in OpenAlex.
- Laboratory risk indicator for necrotising fasciitis (LRINEC) score for the assessment of early necrotising fasciitis: a systematic review of the literature.Annals of the Royal College of Surgeons of England · 2017Pooled it
- Article
- Article
- Refractory Cervical Necrotizing Fasciitis Successfully Controlled by Submandibular Gland Excision: A Case Report.Clinical case reports · 2026Article
- Outcomes of invasive Strep A infections of upper limb treated in a regional centre over a period of a one year: case series and literature review.Journal of surgical case reports · 2026Article
- When Drainage is Not Enough in Emphysematous Pyelonephritis Complicated by Necrotizing Fasciitis: A Case Report.Cureus · 2026Article
- Article
- Necrotizing Fasciitis Caused byInfection and drug resistance · 2026Article
- Diagnostic strategies in necrotizing soft tissue infections: from clinical scores to multi-omics and machine learning.Burns & trauma · 2026Review
- Predictors of clinical outcomes in necrotizing fasciitis: a ten year study.International orthopaedics · 2025Article
- Managing Necrotizing Soft Tissue Infections of the Lower Limb: Microsurgical Reconstruction and Hospital Resource Demands-A Case Series from a Tertiary Referral Center.Journal of clinical medicine · 2025Article
- To perform or not to perform fasciotomy? A rare case report.Joint diseases and related surgery · 2025Article
- Invasive group A Streptococcus infection (Streptococcus pyogenes): Current situation in Spain.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2024Article
- Pediatric Necrotizing Fasciitis.Journal of the Pediatric Orthopaedic Society of North America · 2023Review
- Risk Factors for Predicting Mortality and Amputation of Patients with Necrotizing Soft-Tissue Infections: Retrospective Analysis of 111 Cases from a Single Medical Center.Emergency medicine international · 2023Article
- Suggested organism entry portal of necrotizing fasciitis with complete DNA from fascia, blood, and pharyngeal ulcers: A case report.Annals of medicine and surgery (2012) · 2022Article
- Retroperitoneal necrotizing soft tissue infections: A case report and literature review.Clinical case reports · 2022Article
- Necrotizing Soft Tissue Infections in Intensive Care.Journal of intensive care medicine · 2022Observational
- Patient Characteristics and Outcomes in Necrotizing Soft-tissue Infections: Results from a Prospective Cohort Study in a Tertiary Care Center Intensive Care Unit in South India.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2022Article
- Necrotizing soft tissue infection: clinical characteristics, diagnosis, and management of 32 cases in Beijing.The Journal of international medical research · 2021Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionNecrotising soft tissue infection (NSTI) is a rare but life threatening diagnosis. Geographic, economic and social variances influence presentation and prognosis. As the current literature does not reflect a UK metropolitan population, we conducted a retrospective chart review to establish pertinent features relevant to our practice.
methodsPatients with histologically confirmed diagnoses of NSTI presenting to two London teaching hospitals between January 2007 and July 2013 were included in the study. Features of presentation, surgical and medical management, microbiological findings and outcome were evaluated.
resultsTwenty-four patients with histologically confirmed NSTI were included. Two age clusters were identified, with means of 46 years (standard deviation [SD]: 10 years) and 80 years (SD: 6 years). Pain, erythema and sepsis were common findings. Hypertension, hypercholesterolaemia and type II diabetes mellitus were common co-morbidities. A third of younger patients had human immunodeficiency virus or hepatitis C, with a quarter dependent on drugs and/or alcohol. The mean Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC) score was 5.8 (SD: 3.3). The lower extremities, groin and perineum were common sites of infection. Fourteen patients required inotropic support and seventeen required transfusions. The median number of surgical procedures was 5 (range: 1-17). Group A Streptococcus was the most frequently identified pathogen. Five patients died. Being elderly, female sex and failure to use clindamycin as a first-line antibiotic were associated with significantly higher mortality.
conclusionsIn contrast to other recent series, group A streptococcal monomicrobial NSTI remains the most common presentation in our population. Survival is anticipated in young patients, regardless of premorbid status. Elderly patients have a poor prognosis. The negative predictive value of the LRINEC score is questioned. Use of clindamycin as a first-line antibiotic is supported.
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