Necrotizing fasciitis

Necrotizing fasciitis is an infection of the skin that has eroded deeply into the tissue underneath the skin and has made the patient very sick. Typically patients have high fevers and elevated white-blood-cell counts. They feel terrible and often need to go to the emergency room.

Necrotizing fasciitis is very concerning as the infection beneath the skin can be much larger and far more severe than what is apparent on the skin surface. Necrotizing fasciitis can be difficult to diagnose. There are scoring systems that we use to help guide our management, but occasionally exploratory surgery is necessary to make the diagnosis.


Bacteria at a microscopic level (artist's rendering). Necrotizing fasciitis is caused by a bacterial infection.

Unfortunately, the tissue destruction can be very severe and life-threatening. The infection can be cured only by removing all of the skin and fat tissue overlying the deeper infected area. The important thing to remember is that the radical surgery is meant to save the patient’s life; concerns for reconstruction must come later.

The most common areas for this type of infection are in the lower leg, the lower abdominal wall, and in the groin area, but it can occur anywhere on your body. The risk factors include being overweight and having diabetes.

After the radical surgery to cure the infection, frequent dressing changes are performed until the wound begins to heal. Reconstruction is often performed with skin grafts taken from other parts of the body. Patients with necrotizing fasciitis of the leg are worried about amputation, and unfortunately, sometimes one is required. However, amputations are needed in only a small percentage of patients.

There is no real prevention for necrotizing fasciitis. Diabetics should track their sugars and keep their diabetes in good control. Edema or swelling of the legs is a problem that should not be ignored. If your legs are always swollen, you should see your doctor for diagnosis and treatment. Necrotizing fasciitis is another disease commonly associated with obesity, so work to maintain a healthy diet and an exercise program.