{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T16:32:32Z","timestamp":1789749152272,"version":"4.0.1"},"reference-count":35,"publisher":"Frontiers Media SA","content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"DOI":"10.3389\/fsurg.2017.00005","type":"journal-article","created":{"date-parts":[[2017,2,7]],"date-time":"2017-02-07T04:12:57Z","timestamp":1486440777000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":67,"title":["Early Diagnosis and Surgical Treatment for Necrotizing Fasciitis: A Multicenter Study"],"prefix":"10.3389","volume":"4","author":[{"given":"Evangelos P.","family":"Misiakos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Bagias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iordanis","family":"Papadopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nickolaos","family":"Danias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Patapis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nickolaos","family":"Machairas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore","family":"Karatzas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nickolaos","family":"Arkadopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Toutouzas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nickolaos","family":"Alexakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manousos N.","family":"Konstantoulakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Zografos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasilis","family":"Smyrniotis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Kouraklis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasios","family":"Machairas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2017,2,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1016\/S0003-4975(97)00514-6","article-title":"Necrotizing soft tissue infections of the chest wall","volume":"64","author":"Urschel","year":"1997","journal-title":"Ann Thorac Surg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1016\/j.clindermatol.2004.06.014","article-title":"Life-threatening necrotizing fasciitis","volume":"23","author":"Levine","year":"2005","journal-title":"Clin Dermatol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/j.suc.2013.10.011","article-title":"Necrotizing skin and soft tissue infections","volume":"94","author":"Kaafarani","year":"2014","journal-title":"Surg Clin North Am"},{"issue":"6","key":"B4","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1186\/1749-7922-6-46","article-title":"Necrotizing fasciitis: literature review of contemporary strategies for diagnosing and management with three case reports: torso, abdominal wall, upper and lower limbs","volume":"23","author":"Roje","year":"2011","journal-title":"Word J Emerg Surg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1454","DOI":"10.2106\/00004623-200308000-00005","article-title":"Necrotizing fasciitis: clinical presentation, microbiology, and determinants of mortality","volume":"85","author":"Wong","year":"2003","journal-title":"J Bone Joint Surg Am"},{"key":"B6","first-page":"96","article-title":"Factors affecting mortality in Hong Kong patients with upper limb necrotising fasciitis","volume":"17","author":"Yeung","year":"2011","journal-title":"Hong Kong Med J"},{"key":"B7","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1159\/000339161","article-title":"Prognostic aspects, survival rate, and predisposing risk factors in patients with Fournier\u2019s gangrene and necrotizing soft tissue infections: evaluation of clinical outcome of 55 patients","volume":"89","author":"Martinschek","year":"2012","journal-title":"Urol Int"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1576","DOI":"10.1097\/TA.0b013e318270d761","article-title":"The laboratory risk indicator for necrotizing fasciitis score for discernment of necrotizing fasciitis originated from Vibrio vulnificus infections","volume":"73","author":"Chao","year":"2012","journal-title":"J Trauma Acute Care Surg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.2169\/internalmedicine.49.2964","article-title":"Necrotizing fasciitis","volume":"49","author":"Shimizu","year":"2010","journal-title":"Intern Med"},{"key":"B10","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1016\/j.jamcollsurg.2008.10.032","article-title":"Necrotizing fasciitis: current concepts and review of the literature","volume":"208","author":"Sarani","year":"2009","journal-title":"J Am Coll Surg"},{"key":"B11","first-page":"532","article-title":"Fournier\u2019s gangrene: our experience in 5 years, bibliographic review and assessment of the Fournier\u2019s gangrene severity index","volume":"62","author":"Morua","year":"2009","journal-title":"Arch Esp Urol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1002\/bjs.9371","article-title":"Early diagnosis of necrotizing fasciitis","volume":"101","author":"Goh","year":"2014","journal-title":"Br J Surg"},{"key":"B13","doi-asserted-by":"publisher","first-page":"2742","DOI":"10.1016\/j.juro.2009.08.050","article-title":"Fournier\u2019s gangrene: management and mortality predictors in a population based study","volume":"182","author":"Sorensen","year":"2009","journal-title":"J Urol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1662","DOI":"10.7860\/JCDR\/2013\/5535.3240","article-title":"Necrotising soft tissue infection-risk factors for mortality","volume":"7","author":"Kalaivani","year":"2013","journal-title":"J Clin Diagn Res"},{"key":"B15","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1007\/s00423-008-0461-9","article-title":"Fournier\u2019s gangrene: is the female gender a risk factor?","volume":"395","author":"Czymek","year":"2010","journal-title":"Langenbecks Arch Surg"},{"key":"B16","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1186\/1749-7922-8-13","article-title":"Fournier\u2019s gangrene: our experience with 50 patients and analysis of factors affecting mortality","volume":"8","author":"Benjelloun el","year":"2013","journal-title":"World J Emerg Surg"},{"key":"B17","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1001\/archsurg.140.2.151","article-title":"Predictors of mortality and limb loss in necrotizing soft tissue infections","volume":"140","author":"Anaya","year":"2005","journal-title":"Arch Surg"},{"key":"B18","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1007\/s11751-011-0116-1","article-title":"Necrotizing fasciitis of the extremities a prospective study","volume":"6","author":"Espandar","year":"2011","journal-title":"Strategies Trauma Limb Reconstr"},{"key":"B19","first-page":"49","article-title":"Causes, presentation and survival of fifty-seven patients with necrotizing fasciitis of the male genitalia","volume":"170","author":"Clayton","year":"1990","journal-title":"Surg Gynecol Obstet"},{"issue":"1","key":"B20","doi-asserted-by":"publisher","first-page":"36","DOI":"10.3389\/fsurg.2014.00036","article-title":"Current concepts in the management of necrotizing fasciitis","volume":"29","author":"Misiakos","year":"2014","journal-title":"Front Surg"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1644","DOI":"10.1378\/chest.101.6.1644","article-title":"Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP\/SCCM Consensus Conference Committee. American College of Chest Physicians\/Society of Critical Care Medicine","volume":"101","author":"Bone","year":"1992","journal-title":"Chest"},{"key":"B22","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1097\/00000658-199611000-00011","article-title":"NSTI-risk factors for mortality and strategies for management","volume":"224","author":"Elliott","year":"1996","journal-title":"Ann Surg"},{"key":"B23","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1080\/11024150260284897","article-title":"Necrotising infections of soft tissues \u2013 a clinical profile","volume":"168","author":"Singh","year":"2002","journal-title":"Eur J Surg"},{"key":"B24","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1016\/j.jemermed.2007.03.041","article-title":"Community-acquired necrotizing soft tissue infections: a review of 122 cases presenting to a single emergency department over 12 years","volume":"34","author":"Frazee","year":"2008","journal-title":"J Emerg Med"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1677","DOI":"10.1097\/01.CCM.0000170199.43624.B8","article-title":"Clinical relevance of the LRINEC (laboratory risk indicator for necrotizing fasciitis) score for assessment of early necrotizing fasciitis","volume":"33","author":"Wong","year":"2005","journal-title":"Crit Care Med"},{"key":"B26","doi-asserted-by":"publisher","first-page":"785","DOI":"10.1016\/0002-9610(83)90140-X","article-title":"Early diagnosis, nutrition support, and immediate extensive debridement improve survival necrotizing fasciitis","volume":"145","author":"Majeski","year":"1983","journal-title":"Am J Surg"},{"key":"B27","doi-asserted-by":"publisher","first-page":"2683","DOI":"10.1002\/lary.23680","article-title":"Retrospective evaluation of laboratory-based diagnostic tools for cervical necrotizing fasciitis","volume":"122","author":"Thomas","year":"2012","journal-title":"Laryngoscope"},{"key":"B28","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/j.asjsur.2012.04.006","article-title":"Prognostic factors in Fournier gangrene","volume":"35","author":"Ruiz-Tovar","year":"2012","journal-title":"Asian J Surg"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1545","DOI":"10.1128\/JCM.01895-07","article-title":"Human fulminant gas gangrene caused by Clostridium chauvoei","volume":"46","author":"Nagano","year":"2008","journal-title":"J Clin Microbiol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/j.amjsurg.2007.08.076","article-title":"Approach to debridement in necrotizing fasciitis","volume":"196","author":"Wong","year":"2008","journal-title":"Am J Surg"},{"key":"B31","first-page":"7","article-title":"Necrotizing soft tissue infections: obstacles in diagnosis","volume":"182","author":"Lille","year":"1996","journal-title":"J Am Coll Surg"},{"key":"B32","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1191\/0961203306lu2314cr","article-title":"Necrotizing fasciitis in rheumatic diseases","volume":"15","author":"Mok","year":"2006","journal-title":"Lupus"},{"key":"B33","doi-asserted-by":"publisher","first-page":"224","DOI":"10.3325\/cmj.2008.2.224","article-title":"Influence of adjuvant hyperbaric oxygen therapy on short-term complications during surgical reconstruction of upper and lower extremity war injury: a retrospective cohort study","volume":"49","author":"Roje","year":"2008","journal-title":"Croat Med J"},{"key":"B34","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1302\/0301-620X.83B5.10987","article-title":"Necrotising fasciitis of a limb","volume":"83","author":"Tang","year":"2001","journal-title":"J Bone Joint Surg Br"},{"key":"B35","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1086\/511638","article-title":"Necrotizing soft-tissue infection: diagnosis and management","volume":"44","author":"Anaya","year":"2007","journal-title":"Clin Infect Dis"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"http:\/\/journal.frontiersin.org\/article\/10.3389\/fsurg.2017.00005\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,6,25]],"date-time":"2017-06-25T09:55:23Z","timestamp":1498384523000},"score":1,"resource":{"primary":{"URL":"http:\/\/journal.frontiersin.org\/article\/10.3389\/fsurg.2017.00005\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,2,7]]},"references-count":35,"URL":"https:\/\/doi.org\/10.3389\/fsurg.2017.00005","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,2,7]]}}}