Pattern and challenges of managing necrotizing fasciitis in a sub-Saharan tertiary hospital

Background and objectives: Necrotizing fasciitis is a severe soft tissue infection that can affect the cervicofacial region. The management requires aggressive surgical debridement under general anaesthesia and supportive therapy. In our environment patients presenting with this infection are usually financially incapacitated and therefore cannot afford the ideal line of management. This paper aims to document the pattern and challenges encountered in the management of cervicofacial necrotizing fasciitis in the University College Hospital, Ibadan.

Materials and methods: Data was prospectively collected on all patients who presented at the department of Oral and Maxillofacial Surgery with cervicofacial necrotizing fasciitis in the maxillofacial region between January 2007 and December 2012. The patients were managed according to a devised protocol of antibiotic therapy, serial debridement and honey dressings. Information on age, gender, site and source of infection, identified systemic conditions, socioeconomic class, widest span of resultant defect, management provided, days on admission and outcome of management.

Results: Seventeen cases of cervicofacial necrotizing fasciitis were seen. There were 6 males and 11 females. The mean age at presentation was 42.5 (±23.000) years while 70.59% of the patients belonged to the low socioeconomic class. The mean span of wound defect was 11.3 (±8.573) cm. Outcome of management was satisfactory with scar formation only in 47.06% of the cases. A single case of mortality was recorded.

Conclusion: The management of necrotizing fasciitis in the maxillofacial region poses a significant challenge to the maxillofacial surgeon in our environment as majority of our patients are unable to afford the ideal line of management. Despite this, mortality rate was low and outcome of management was acceptable.

Key word: cervicofacial necrotizing fasciitis

Disclosure: Nil.

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Jan 21, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Pattern and challenges of managing necrotizing fasciitis in a sub-Saharan tertiary hospital
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