KnotesFree Orthopaedic & FRCS notes, viva stations and higher order SBAs

Necrotising fasciitis

High YieldApplied Basic SciencesthinKbox SBA

Definition

A rapidly progressive, life-threatening soft-tissue infection involving fascia and subcutaneous tissues.

Clinical features

  • Pain out of proportion to findings
  • Rapid progression
  • Swelling, erythema and systemic toxicity
  • Skin discolouration, bullae or crepitus may develop late

Risk factors

  • Diabetes
  • Immunosuppression
  • Peripheral vascular disease
  • Penetrating trauma or surgery

Management

  • Immediate resuscitation
  • Broad-spectrum intravenous antibiotics
  • Urgent and aggressive surgical debridement
  • Re-look debridement often required
  • Critical care support

Key point

Do not delay debridement for imaging if the diagnosis is strongly suspected.

Diagram

Necrotising fasciitis

Written/reviewed by Kishore Puthezhath

Professor of Orthopaedics and Consultant Paediatric Orthopaedic Surgeon

FRCS (Tr & Orth) revision resource

Reviewed: September 2026