Investigation and Management

Investigation and management of necrotising fasciitis comprises of the following:

• Blood cultures and arterial blood gases should be performed
• Empiric broad spectrum antibiotics should be administered immediately
• Other investigations that may assist diagnosis are plain x-ray (showing gas in tissues – click on the x-ray to enlarge) and CT (showing gas dissecting along fascial planes)

However, any suspicion of necrotising fasciitis requires immediate surgical referral and assessment by an experienced surgeon. The patient will also require intensive care, so early involvement of intensivists is necessary.

Learning bite

Any patient with suspected necrotising fasciitis requires immediate surgical referral for debridement and exploration in theatre.