{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T19:48:25Z","timestamp":1793994505800,"version":"4.8.0"},"reference-count":24,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2015,7,24]],"date-time":"2015-07-24T00:00:00Z","timestamp":1437696000000},"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":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The aims of this paper were to review our experience with necrotizing fasciitis at <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>iddlemore <jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>ospital and to define the trends in incidence, inpatient mortality and microbiological profile.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A computerized search of the electronic medical records was undertaken to identify adult patients with a diagnosis of necrotizing fasciitis between <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>anuary 2000 and <jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>ecember 2010. A retrospective review of the clinical records was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 138 patients with necrotizing fasciitis identified, 129 had their diagnosis confirmed at operation. The mortality at 30 days was 20.3% (95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) 13.9%\u201328.0%). There was a significant reduction in hospital mortality in each successive year of the study period with an odds ratio of 0.84 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.71\u20130.98, <jats:italic>P<\/jats:italic> = 0.03). A pattern of increasing incidence was noted until <jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>ebruary 2004 (95% <jats:styled-content style=\"fixed-case\">CI S<\/jats:styled-content>eptember 2002\u2013<jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>uly 2005). This was followed by a significant decrease in incidence. The empirical antibiotic regime of clindamycin, gentamicin and penicillin provides satisfactory cover against 95% of the causative pathogens.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This represents the largest single\u2010centre published case series in <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>ew <jats:styled-content style=\"fixed-case\">Z<\/jats:styled-content>ealand. Despite concerns of increasing incidence and mortality associated with necrotizing fasciitis in <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>ew <jats:styled-content style=\"fixed-case\">Z<\/jats:styled-content>ealand, the experience in <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>outh <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>uckland shows a decrease in incidence of necrotizing fasciitis since 2004 and a statistically significant decreasing trend in hospital mortality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.13232","type":"journal-article","created":{"date-parts":[[2015,7,24]],"date-time":"2015-07-24T10:48:49Z","timestamp":1437734929000},"page":"826-830","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Necrotizing fasciitis: 11\u2010year retrospective case review in <scp>S<\/scp>outh <scp>A<\/scp>uckland"],"prefix":"10.1111","volume":"86","author":[{"given":"Suheelan","family":"Kulasegaran","sequence":"first","affiliation":[{"name":"Department of Surgery South Auckland Clinical School The University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Cribb","sequence":"additional","affiliation":[{"name":"Department of Surgery South Auckland Clinical School The University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain C.","family":"Vandal","sequence":"additional","affiliation":[{"name":"Ko Awatea Counties Manukau Health Middlemore Hospital  Auckland New Zealand"},{"name":"Faculty of Health and Environmental Sciences Auckland University of Technology  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"McBride","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Middlemore Hospital  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Holland","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Middlemore Hospital  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew D.","family":"MacCormick","sequence":"additional","affiliation":[{"name":"Department of Surgery Manukau Health Middlemore Hospital  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,7,24]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"232","article-title":"Necrotising fasciitis: an 8.5\u2010year retrospective case review in a New Zealand Intensive care unit","volume":"13","author":"Mitchell A","year":"2011","journal-title":"Crit. 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