Soft Tissue Case 1 ED Management

 

Definitive treatment is surgical debridement.

Early surgical consultation is crucial once the diagnosis is suspected as survival and limb salvage are improved if patients are taken to the OR within 6-12 hours from presentation. ⁴

Empiric antibiotics should be started when the diagnosis is first considered and should cover aerobic and anaerobic organisms. Clindamycin, piperacillin-tazobactam, and vancomycin is an example of an appropriate regimen. Do not delay administration of antibiotics for other tests. The staph and strep species that frequently cause necrotizing fasciitis produce exotoxins that are inhibited by clindamycin and linezolid so one of these antibiotics should be included in the regimen. ⁵