https://www.vetnurse.co.uk/f/clinical-discussions/32022/what-is-the-best-wound-care-treatment-for-necrotising-fasciitis Hello, What would be the best wound care/treatment for a necrotising fasciitis case? Thanks en-USTelligent Community 10https://www.vetnurse.co.uk/thread/176331?ContentTypeID=1Mon, 10 Aug 2020 12:52:05 GMT1a0763ec-3885-442c-853e-6cef656dfec5:c4d5122f-f650-4d9c-8b48-fb8e97aae6d5Sam2311<p>Hi Georgie, thanks so much for your reply. This was a case I saw years ago and used for my portfolio (back in the day!) The vet believed it was necrotising fasciitis as have you have said it happened very quickly. We used manuka honey dressing and tried to get it to heal by secondary intention. It took weeks andband weeks but eventually it did heal.&nbsp;</p> <p>Thanks</p> <p></p> <p>Sam</p><div style="clear:both;"></div>https://www.vetnurse.co.uk/thread/176290?ContentTypeID=1Tue, 04 Aug 2020 20:52:32 GMT1a0763ec-3885-442c-853e-6cef656dfec5:de41bee5-76de-423c-8863-05ed213ae9a7Georgie Hollis<p>Hi Sam, this is a really good question. I&#39;m not sure how many people will have seen a true case of necrotising fasciitis but once seen never forgotten.&nbsp;If necrotising fasciitis is&nbsp;suspected the signs will be a rapid spread of infection, maybe from a site of blunt or sharp trauma. Initial swelling, ischaemia and necrosis may be identified typically as Streptococcus canis in origin but there are other species of bacteria that can cause the same effect. Staphylococcus intermedius (the normal flora of canine skin) may also cause this potentially fatal infection.</p> <p>So for those that have not come across it. True necrotising fasciitis is a rapidly developing necrosis, we are talking a very fast spreading infection (redness, inflammation, systemic infection and necrosis) in what appears to be minutes to a few hours rather than the days that may be more normal.</p> <p>So what will you see? Redness, swelling, then blackening tissue that spreads rapidly (perhaps 30 minutes, to a couple of hours from the site of injury to other areas.)&nbsp;</p> <p>What should you do? Get your vet immediately.&nbsp;</p> <p><span>The bacteria&nbsp;involved needs to be&nbsp;isolated as early as possible. After (immediately - even&nbsp;before results!) rapid and aggressive&nbsp;debridement. In humans amputation may not be an&nbsp;unreasonable solution to prevent spread.</span></p> <p><span>If dressings are sought, then they are really only relevant after the&nbsp;debridement has taken place and there should be confidence that the pathogen is under control or totally removed. Any topical&nbsp;management once the infection is systemic is unlikely to salvage tissue so dressings are not primary to resolving the issue.&nbsp;</span></p> <p><span>Once the infection is under control (surgically) then dressing selection will be the same as any other wound. If the tissue is red and vascular then hydrogel + absorbent dressing will suffice. In all honesty, in this kind of condition&nbsp;there should be no bacteria/pathogen left - so healthy red, vascular tissue&nbsp;should be all that is left to dress. You can use Honey, but really if&nbsp;there is pathogen left, then the job wasn&#39;t done properly. (if you see what i&nbsp;mean). I wouldn&#39;t be surprised if surgical closure is what you are dealing with in terms of amputation - in which case you just need to prevent cross contamination.&nbsp;</span></p> <p><span>I think its a bit of a case of what is left after the necrotising fasciitis - it will either be a surgically closed amputation, or exposed tissue that needs to granulate. Treat both as you would normally. If the infection is not removed, that is a surgical issue. (although honey and silver may be a backup - its not a substitute for good surgery!)&nbsp;</span></p> <p><span></span></p> <p>I hope that makes sense!&nbsp;</p><div style="clear:both;"></div>