What Researchers Did
Researchers conducted a literature review using Medline and Cochrane library, supported by a multidisciplinary expert panel, to examine all aspects of care for critically ill patients with necrotizing skin and soft-tissue infections (NSTI).
What They Found
They found that prompt surgery with aggressive debridement and immediate broad-spectrum antimicrobial therapy, including clindamycin, are crucial for critically ill patients with necrotizing skin and soft-tissue infections (NSTI). The initial presentation can be misleading, and delayed surgery worsens prognosis, while the utility of clinical scores, immunoglobulins, and hyperbaric oxygen therapy remains controversial, with many aspects of management supported by low-quality data.
What This Means for Canadian Patients
Canadian patients with necrotizing skin and soft-tissue infections (NSTI) require rapid diagnosis and immediate, aggressive surgical debridement combined with broad-spectrum antibiotics to improve outcomes. Access to specialized multidisciplinary care, involving intensive care, surgery, microbiology, and infectious diseases, is vital for effective management of these severe infections.
Canadian Relevance
This study has no direct Canadian connection as it is a general review of international literature.
Study Limitations
A significant limitation is that many aspects of necrotizing skin and soft-tissue infection management are currently supported by low-quality data, highlighting the urgent need for multicentre trials.