{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T16:43:31Z","timestamp":1789663411675,"version":"4.0.1"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,1,8]],"date-time":"2022-01-08T00:00:00Z","timestamp":1641600000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,1,8]],"date-time":"2022-01-08T00:00:00Z","timestamp":1641600000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Surg"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The primary aim of this study was to identify if there is an association between the operative time of the initial debridement for necrotizing soft tissue infections (NSTIs) and the mortality corrected for disease severity.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A retrospective multicenter study was conducted of all patients with NSTIs undergoing surgical debridement. The primary outcome was the 30-day mortality. The secondary outcomes were days until death, length of intensive care unit (ICU) stay, length of hospital stay, number of surgeries within first 30\u00a0days, amputations and days until definitive wound closure.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 160 patients underwent surgery for NSTIs and were eligible for inclusion. Twenty-two patients (14%) died within 30\u00a0days and 21 patients (13%) underwent an amputation. The median operative time of the initial debridement was 59\u00a0min (IQR 35\u201390). In a multivariable analyses, corrected for sepsis just prior to the initial surgery, estimated total body surface (TBSA) area affected and the American Society for Anesthesiologists (ASA) classification, a prolonged operative time (per 20\u00a0min) was associated with a prolonged ICU (\u03b2 1.43, 95% CI 0.46\u20132.40; <jats:italic>p<\/jats:italic>\u2009=\u20090.004) and hospital stay (\u03b2 3.25, 95% CI 0.23\u20136.27; <jats:italic>p<\/jats:italic>\u2009=\u20090.035), but not with 30-day mortality. Operative times were significantly prolonged in case of NSTIs of the trunk (<jats:italic>p<\/jats:italic>\u2009=\u20090.044), in case of greater estimated TBSA affected (<jats:italic>p<\/jats:italic>\u2009=\u20090.006) or if frozen sections and\/or Gram stains were assessed intra-operatively (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Prolonged initial surgery did not result in a higher mortality rate, possible because of\u00a0a short duration of surgery in most studied patients. However, a prolonged operative time was associated with a prolonged ICU and hospital stay, regardless of the estimated TBSA affected, presence of sepsis prior to surgery and the ASA classification. As such, keeping operative times as limited as possible might be beneficial for NSTI patients.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12893-021-01456-0","type":"journal-article","created":{"date-parts":[[2022,1,8]],"date-time":"2022-01-08T03:02:47Z","timestamp":1641610967000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The impact of operative time on the outcomes of necrotizing soft tissue infections: a multicenter cohort study"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8390-4483","authenticated-orcid":false,"given":"Femke","family":"Nawijn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"van Heijl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jort","family":"Keizer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul J.","family":"van Koperen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Falco","family":"Hietbrink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,1,8]]},"reference":[{"issue":"8","key":"1456_CR1","doi-asserted-by":"publisher","first-page":"1454","DOI":"10.2106\/00004623-200308000-00005","volume":"85","author":"CH Wong","year":"2003","unstructured":"Wong CH, Chang HC, Pasupathy S, Khin LW, Tan JL, Low CO. 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