Necrotizing fasciitis: A comprehensive review.
Leon L Chen, Brian Fasolka, Caitlin Treacy
PMID 32826674WHAT IT FOUND
Necrotizing fasciitis often mimics cellulitis but progresses rapidly to septic shock.
Nurses must monitor for pain disproportionate to visible injury and hemodynamic instability, as delays in surgical debridement and broad-spectrum antibiotics significantly increase mortality.
Key findings
01Mortality remains high at 25% to 35% due to rapid disease progression and subtle early signs that delay diagnosis.
02Surgical exploration is the only way to establish the diagnosis, and intervention should not be delayed for imaging.
03Nurses should assess for localized erythema, warmth, tenderness disproportionate to the affected area, and signs of sepsis.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
As a narrative review, it does not present new primary data or a systematic search strategy. The paper notes that LRINEC scores failed to accurately predict NF in subsequent reports, limiting the utility of this screening tool. The role of hyperbaric oxygen and IVIG remains controversial and is not definitively supported by large randomized studies.
Declared interests
The authors and planners have disclosed no potential conflicts of interest, financial or otherwise.
The easy way to misread this
Do not rely on superficial skin findings or initial mild symptoms to rule out necrotizing fasciitis. The paper states that critical diagnostic distinctions are difficult to discern early, and patients can be largely asymptomatic or have mild signs that mimic benign disorders, while the infection progresses rapidly in deep tissues.