Necrotizing Soft Tissue Infections of the Upper Extremity

Hand Clin. 2020 Aug;36(3):339-344. doi: 10.1016/j.hcl.2020.03.007.

Abstract

Necrotizing soft tissue infections of the upper extremity have varying microbiologies and etiologies. Risk factors for development include diabetes mellitus, intravenous drug use, peripheral arterial disease, smoking, alcohol abuse, and immunocompromised state. Although clinical examination is the mainstay of diagnosis, laboratory tests and imaging can aid in diagnosis. Surgical débridements usually are needed for treatment, with resultant defects that often require reconstruction. Rates of amputation are reported as 22% to 37.5% and mortality from necrotizing soft tissue infections of the upper extremity from 22% to 34%. Prompt surgical and antimicrobial treatment is necessary to decrease risk of loss of limb or life.

Keywords: Hand infection; NSTI; Necrotizing soft tissue infection.

Publication types

  • Review

MeSH terms

  • Amputation, Surgical
  • Anti-Bacterial Agents / therapeutic use
  • Debridement
  • Fasciotomy
  • Humans
  • Medical History Taking
  • Necrosis / therapy*
  • Physical Examination
  • Soft Tissue Infections / therapy*
  • Surgical Flaps
  • Upper Extremity / pathology
  • Upper Extremity / surgery*

Substances

  • Anti-Bacterial Agents