Principles of managing necrotising skin and soft tissue infections
Seek expert advice for the treatment of necrotising skin and soft tissue infection.
Surgical removal of devitalised tissue and urgent antibiotic therapy are essential for management – multiple debridements are often required. If hyperbaric oxygen therapy is used as an adjunct to surgical debridement, it should not delay surgery.
Empirical antibiotic therapy is used while the pathogen(s) and affected tissues are determined. Empirical regimens are included in this topic for necrotising skin and soft tissue infection:
In people wounded in natural disasters, if evacuation and debridement is delayed, necrotising skin and soft tissue infection caused by Clostridium species should be considered – see Clostridial necrotising skin and soft tissue infection.
Modify therapy when the results of Gram stain, culture and susceptibility testing of a surgical deep tissue sample are available.
The management of necrotising skin and soft tissue infections in neonates is beyond the scope of these guidelines. Seek advice from a neonatal intensive care service.