Red Flags: Recognizing necrotizing fasciitis
Leslee H. Shepard EdD, MSN, RN, CMSRN

Nursing Made Incredibly Easy!
February 2013 
Volume 11  Number 1
Pages 51 - 53
  PDF Version Available!

Necrotizing fasciitis (NF) is a bacterial infection of the subcutaneous skin tissue and fascia. This type of bacterial infection has been around for hundreds of years, but the term necrotizing fasciitis wasn't coined until the early 1950s. To help simplify the meaning, remember that necrotizing means to cause tissue to die and fasciitis is inflammation of the fascia-the connective tissue throughout the body that supports muscles and organs.A life-threatening condition, NF progresses rapidly and is so gruesome that it's popularly known as the flesh-eating bacteria. The infection can be caused by more than one type of bacterium, including the invasive group A streptococci (group A strep). In most cases, infections from group A strep aren't life threatening and may even be mild, such as in strep throat. However, if bacteria release harmful toxins, they'll kill tissue and affect blood flow to the affected area, causing tissue death. This tissue death allows the bacteria to enter the blood and spread quickly.Although very rare, NF is extremely dangerous, so make sure you can recognize evidence of the infection. The sooner treatment begins, the better the patient's chances for survival.NF can affect people of any age. The infection develops when bacteria enter the body through a wound, even something as minor as a small cut or scrape. Some preexisting conditions that have been linked to NF include diabetes, alcoholism, surgical wounds, and immunocompromise.NF can affect any part of the body, but the most commonly reported areas are the extremities, perineum, and truncal regions of the body. It has been categorized into three types based on portal of entry; however, all present with similar signs and symptoms. Type I (polymicrobial) usually occurs after surgery or trauma. Type II, or group A strep, most often results from a simple break in the skin. Type III affects the skeletal muscle (gas gangrene) and, as with Type I, is associated with surgery or trauma. See Types of NF

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