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Overview

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Necrotizing soft tissue infections (NSTI)

NSTI is a life-threatening, rapidly progressing soft-tissue infection primarily involving the superficial fascia. It is a severe medical condition with high morbidity and mortality that requires a multi-disciplinary approach to care. The infection tracks along the fascial planes, causing thrombosis of blood vessels running through the fascia with resulting necrosis of the skin, subcutaneous fat and even muscle. Broad anti-bacterial therapy is inadequate and there are currently no available therapeutics approved for this indication. The principles of management include early diagnosis with prompt and repeated aggressive surgical debridement, aggressive resuscitation and physiologic support in a critical care setting, in addition to antimicrobial drugs. NSTI can be caused by a variety of virulent bacteria. The incidence of NSTI is estimated at 25-29,000 cases/year in the US with mortality of 15-20%.