A Comparative Study on the Incidence of Necrotizing Fasciitis in Diabetics and Non-Diabetics and the Various Factors Influencing Its Outcome (T0196)

Introduction: Necrotizing fasciitis (NF) is a life-threatening soft tissue infection characterized by rapid progression and significant morbidity. Diabetes mellitus (DM) is a known predisposing factor for NF, contributing to altered immune responses and delayed wound healing. Understanding the incidence and outcome determinants in diabetics and non-diabetics is crucial for timely intervention and improved management.

Aims and Objectives:

Aim: Diabetes mellitus is most common co-morbidity associated with necrotising fasciitis. This study aims to compare the clinical presentation, Laboratory risk indicator for necrotising fasciitis (LRINEC) score, microbiology and outcome of management of this condition in diabetic and non-diabetic patients.

Objective: Through this study we would like to ascertain the incidence of necrotizing fasciitis and the factors influencing on its outcome. 

Methods: This prospective comparative study included 100 patients diagnosed with NF and admitted to a tertiary care center. Patients were divided into diabetic (n=50) and non-diabetic (n=50) groups. Clinical data, laboratory parameters, and treatment modalities, including surgical debridement and antibiotic therapy, were analyzed. Outcomes were assessed in terms of mortality, limb salvage, and duration of hospital stay.

Results: NF incidence was significantly higher in diabetics (60%) than non-diabetics (40%). Diabetics presented with more severe infections and higher rates of multi-organ dysfunction syndrome (MODS). Early surgical intervention and glycemic control improved survival rates in both groups, but diabetics required longer hospital stays and more frequent debridements. Mortality was 25% in diabetics compared to 10% in non-diabetics, with MODS being a critical determinant.

Conclusion: Diabetic patients are at a higher risk of developing NF with worse outcomes due to delayed immune response and associated comorbidities. Early diagnosis, aggressive surgical management, and stringent glycemic control are pivotal for improving survival.

Keywords: Necrotizing fasciitis, diabetes mellitus, soft tissue infection, mortality, surgical debridement, glycemic control.