Necrotizing soft tissue infections for the orthopaedic surgeon

Necrotizing soft tissue infections (NSTI) which include necrotizing fasciitis (NF) are potentially deadly. They more commonly affect men, the elderly and diabetics and are associated with both group A. streptococcus and S. aureus - community acquired MRSA has been responsible for a number of recent cases. Treatment of infections of the extremities often falls to orthopaedic surgeons. Diagnosis remains primarily clinical but such adjuncts as the LRINEC (Laboratory Risk Indicator score for NECrotizing fasciitis) and MRI scanning may be useful. Early definitive debridement within 24 h of admission reduces mortality.