{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T21:57:57Z","timestamp":1787954277691,"version":"build-2784847793"},"reference-count":24,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T00:00:00Z","timestamp":1748822400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Although previous reports on necrotizing fasciitis have suggested that early initial surgery is associated with a better prognosis, the exact \u201cgolden time\u201d for surgery remains undetermined. This single\u2010center, retrospective cohort study included patients with necrotizing fasciitis between December 2011 and December 2023. We described the features of necrotizing fasciitis and evaluated the association between early surgery, mortality, and amputation\u2010free survival in patients with necrotizing fasciitis. A total of 187 patients (median age: 65.5\u2009years; 107 men and 82 women) were included in this study. The microbiological characteristics were generally consistent with those in previous reports from other countries, except for a low prevalence of methicillin resistance among <jats:styled-content style=\"fixed-case\"><jats:italic>Staphylococcus aureus<\/jats:italic><\/jats:styled-content>, a high incidence of Group C or G <jats:italic>Streptococci<\/jats:italic>, and the scarcity of <jats:styled-content style=\"fixed-case\"><jats:italic>Vibrio vulnificus<\/jats:italic><\/jats:styled-content> isolation. The mortality was lower in patients undergoing surgery within 0\u20136\u2009h or 6\u201312\u2009h compared with those after 12\u2009h (14.6%, 16.1%, and 25.6%, respectively), with an adjusted odds ratio of 0.38 for 0\u20136\u2009h (95% confidence interval 0.08\u20131.63) and 0.44 for 6\u201312\u2009h (95% confidence interval 0.07\u20132.51). Furthermore, the mortality and\/or amputation rate was significantly lower when the time to surgery was 0\u20136\u2009h or 6\u201312\u2009h compared with 12\u2009h or more (adjusted odds ratio 0.19 for 0\u20136\u2009h [95% confidence interval 0.05\u20130.62], and 0.23 for 6\u201312\u2009h [95% confidence interval 0.05\u20130.90]). Our findings suggest that an early surgical intervention, particularly within 6 or 12\u2009h after presentation, is associated with lower mortality and amputation rates in patients with necrotizing fasciitis, emphasizing the importance of prompt treatment for optimal outcomes. Further research is required to determine the optimal timing for surgery.<\/jats:p>","DOI":"10.1111\/1346-8138.17806","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T09:10:04Z","timestamp":1748855404000},"page":"1175-1184","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Epidemiology and Early Surgical Intervention in Necrotizing Fasciitis: A Retrospective Cohort Study in Japan"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4471-8498","authenticated-orcid":false,"given":"Chieko","family":"Fujishima","sequence":"first","affiliation":[{"name":"Department of Dermatology Kobe City Medical Center General Hospital  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2614-7193","authenticated-orcid":false,"given":"Yoshinori","family":"Matsuoka","sequence":"additional","affiliation":[{"name":"Department of Emergency Kobe City Medical Center General Hospital  Kobe Japan"},{"name":"Department of Research Support Center for Clinical Research and Innovation, Kobe City Medical Center General Hospital  Kobe Japan"},{"name":"Department of Healthcare Epidemiology Graduate School of Medicine and Public Health, Kyoto University  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7612-2958","authenticated-orcid":false,"given":"Hiroki","family":"Kinoshita","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Akashi Medical Center  Akashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reina","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Dermatology Kobe City Medical Center General Hospital  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yui","family":"Takeda","sequence":"additional","affiliation":[{"name":"Department of Dermatology Kobe City Medical Center General Hospital  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukimasa","family":"Tai","sequence":"additional","affiliation":[{"name":"Department of Dermatology Kobe City Medical Center General Hospital  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanako","family":"Ogura","sequence":"additional","affiliation":[{"name":"Department of Dermatology Kobe City Medical Center General Hospital  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichi","family":"Ariyoshi","sequence":"additional","affiliation":[{"name":"Department of Emergency Kobe City Medical Center General Hospital  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3686-2791","authenticated-orcid":false,"given":"Tohru","family":"Nagano","sequence":"additional","affiliation":[{"name":"Department of Dermatology Kobe City Medical Center General Hospital  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1600673"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-019-0286-6"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1308\/003588414X14055925058553"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu444"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.17325"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjid.2013.08.003"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e31820b372b"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2013.07.461"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2012.05.1021"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc10278"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-024-09501-y"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1346-8138.2008.00432.x"},{"key":"e_1_2_10_14_1","first-page":"1400","article-title":"Necrotizing Soft Tissue Infections: Delayed Surgical Treatment Is Associated With Increased Number of Surgical Debridements and Morbidity","volume":"71","author":"Kobayashi L.","year":"2011","journal-title":"Journal of Trauma"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.4103\/0974-2700.173868"},{"key":"e_1_2_10_16_1","first-page":"33","article-title":"Evaluation of Potential Factors Contributing to Microbiological Treatment Failure in Streptococcus pyogenes Pharyngitis","volume":"12","author":"Kuhn S. 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