Study on influence of LRINEC Scoring System (Lab Risk Factors Influencing Necrotizing Fasciitis), Limb Vascularity and Microbial Flora on outcome of necrotizing fasciitis

AIM OF THE STUDY : To study the influence of the following factors on the outcome of patients with Necrotizing Fasciitis : 1. LRINEC (LAB RISK FACTORS INFLUENCING NECROTIZING FASCIITIS) scoring system, 2. Doppler study of affected limb, 3. Microbial flora. MATERIALS AND METHODS : Patients presenting with signs and symptoms of Necrotizing Fasciitis admitted during August 2013 to August 2014 at Madras Medical College (MMC) and Rajiv Gandhi Govt. General Hospital (RGGGH), were counseled for investigation and treatment of Necrotizing Fasciitis and its complication. 50 patients were treated in the above hospital over the period of 1 year and the results studied. RESULTS : From this study, LRINEC SCORING SYSTEM has been found to be a reliable scoring system in early detection of necrotising fasciitis and in predicting the prognosis of the disease. A score more than 8 is almost definitive of necrotizing fasciitis and mandates active debridement and aggressive management for a better outcome. But DOPPLER ultrasound and microbial flora have not bee found to have significant correlation with the outcome. CONCLUSION: There exists a significant correlation between LRINEC scoring system and prognosis of Necrotizing fasciitis. But there is no significance between the type of MICROBIAL FLORA or VASCULARITY of the affected limb and the outcome of necrotizing fasciitis. Early detection and aggressive debridement are essential in determining the outcome of necrotising fasciitis