{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:26:09Z","timestamp":1753878369767,"version":"3.41.2"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T00:00:00Z","timestamp":1692316800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Necrotizing fasciitis is a progressive and rare disease, with high potential to be life\u2010threatening because of its potential for systemic toxicity. Characterized by fascial infection, it is often followed by systemic toxicity, such as septic shock and multi\u2010organ failure. The aim of this study is to establish reliable data on the treatment of necrotizing fasciitis patients at the topmost referral hospital in West Java, Indonesia. We collected medical record data from January 2015 to December 2021 at Rumah Sakit Umum Pusat Dr. Hasan Sadikin (RSHS), Bandung, Indonesia. We recorded the infection region, bacterial isolates, empirical antibiotics, waiting time for the first surgery, surgical management, length of stay and we analysed the pattern of bacterial isolates, antibiotic use, waiting time for the first surgery, length of stay and mortality. A total of 90 patients' medical records were analysed. We found that the infection was most found in the genitalia and inguinal region (37%). Eighty\u2010five percent of all samples containing gram\u2010negative bacteria. The most used empirical antibiotics were from Cephalosporin class (31%), most of them combined with nitroimidazole (metronidazole) and with quinolones (levofloxacin, ciprofloxacin). Overall mortality rate was 13.3%. Highest mortality rate came from gram\u2010negative bacteria group (14.2%\u201411 out of 77 patients), patients receiving <jats:styled-content style=\"fixed-case\">Ceftriaxone\u2013Metronidazole<\/jats:styled-content> as empirical antibiotics (28.57%\u20144 out of 14 patients), patients with no surgery group (37%\u20143 out of 8 patients), with no mortality came from patients, which were performed debridement followed by fasciotomy\/skin graft\/flap and amputation. We conclude that the most found bacterial aetiology was <jats:italic>Acinetobacter baumanii<\/jats:italic> though it has no significant relation to mortality. We highly recommend early aggressive surgical intervention in reducing mortality rate due to necrotizing fasciitis for source control accompanied by deliberate defect closure and early administration of empirical antibiotics with more susceptibility for gram\u2010negative bacteria, such as Meropenem.<\/jats:p>","DOI":"10.1111\/iwj.14355","type":"journal-article","created":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T09:34:39Z","timestamp":1692437679000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Treating necrotizing fasciitis patients at the topmost referral hospital in West Java, Indonesia: 6\u2009years experience"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5367-463X","authenticated-orcid":false,"given":"Hardisiswo","family":"Soedjana","sequence":"first","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery Rumah Sakit Umum Pusat Dr. Hasan Sadikin\/Universitas Padjadjaran  Kota Bandung Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4006-7675","authenticated-orcid":false,"given":"Sitha","family":"Christine","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery Rumah Sakit Umum Pusat Dr. Hasan Sadikin\/Universitas Padjadjaran  Kota Bandung Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4366-5905","authenticated-orcid":false,"given":"Fransisca","family":"Sisca","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery Rumah Sakit Umum Pusat Dr. Hasan Sadikin\/Universitas Padjadjaran  Kota Bandung Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,8,18]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"735","volume-title":"Grabb and Smith's Plastic Surgery","author":"Chang B","year":"2014"},{"key":"e_1_2_9_3_1","first-page":"341","volume-title":"Plastic Surgery","author":"Bidic SM","year":"2013"},{"issue":"36","key":"e_1_2_9_4_1","first-page":"1","article-title":"Current concepts in the management of necrotizing fasciitis","volume":"1","author":"Misiakos EP","year":"2014","journal-title":"Front Surg"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.18203\/2349-2902.isj20185479"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9371"},{"key":"e_1_2_9_7_1","first-page":"675","volume-title":"Grabb and Smith's Plastic Surgery","author":"Argenta 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