{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T22:43:25Z","timestamp":1792622605716,"version":"4.5.0"},"reference-count":14,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2012,9,19]],"date-time":"2012-09-19T00:00:00Z","timestamp":1348012800000},"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":[[2013,5]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>The aim of this study was to describe the clinical characteristics, causative pathogens, clinical management and outcomes of patients presenting to a tertiary adult Australian intensive care unit (ICU<\/jats:styled-content>) with a diagnosis of necrotizing fasciitis (NF<\/jats:styled-content>).<\/jats:p><\/jats:sec>Methods<\/jats:title>This retrospective observational study was conducted in a 19\u2010bed, level III<\/jats:styled-content>, adult ICU<\/jats:styled-content> in a 450\u2010bed tertiary, regional hospital. Clinical databases were accessed for patients diagnosed with NF and admitted to The G<\/jats:styled-content>eelong H<\/jats:styled-content>ospital ICU<\/jats:styled-content> between 1 F<\/jats:styled-content>ebruary 2000 and 1 J<\/jats:styled-content>une 2011. Information on severity of sepsis, surgical procedures and microbiological results were collected.<\/jats:p><\/jats:sec>Results<\/jats:title>Twenty patients with NF were identified. The median age was 52.5 years and 38% were female. The overall mortality rate was 8.3%. Common co\u2010morbidities were diabetes (21%) and heart failure (17%), although 50% of patients had no co\u2010morbidities. Group A<\/jats:styled-content>\u2005Streptococcus<\/jats:italic> was the identified pathogen in 11 (46%) patients, and S<\/jats:styled-content>treptococcus milleri<\/jats:italic> group in 5 (21%) patients. Hyperbaric oxygen therapy was not used in the majority of patients. The initial antibiotics administered were active against subsequently cultured bacteria in 83% of patients. Median time to surgical debridement was 20\u2009h. Diagnosis and management was delayed in the nosocomial group.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>This study reports physiological data, aetiology and therapeutic interventions in NF for an adult tertiary hospital. We demonstrate one of the lowest reported mortality rates, with early surgical debridement being achieved in the majority of patients. The main delay was found to be in the diagnosis of NF<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1445-2197.2012.06251.x","type":"journal-article","created":{"date-parts":[[2012,9,19]],"date-time":"2012-09-19T04:39:57Z","timestamp":1348029597000},"page":"365-370","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":58,"title":["Early diagnosis and treatment of necrotizing fasciitis can improve survival: an observational intensive care unit cohort study"],"prefix":"10.1111","volume":"83","author":[{"given":"Kelly","family":"Bucca","sequence":"first","affiliation":[{"name":"Department of Anaesthetics The Geelong Hospital Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Spencer","sequence":"additional","affiliation":[{"name":"Department of Medicine The Geelong Hospital Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Orford","sequence":"additional","affiliation":[{"name":"Department of Intensive Care The Geelong Hospital Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Cattigan","sequence":"additional","affiliation":[{"name":"Department of Intensive Care The Geelong Hospital Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene","family":"Athan","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases The Geelong Hospital Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"McDonald","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery The Geelong Hospital Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,9,19]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1128\/9781555816940.ch7"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2007.03.041"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31821cb246"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-5994.2009.02137.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.130.6.1679"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200308000-00005"},{"key":"e_1_2_6_8_1","doi-asserted-by":"crossref","first-page":"2382","DOI":"10.1128\/jcm.33.9.2382-2387.1995","article-title":"Clinical and microbiological features of necrotizing fasciitis","volume":"33","author":"Brook I","year":"1995","journal-title":"J. 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