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- Talk
- 20/09/2022
- UK
Necrotising Fasciitis - What Procedural Challenges and Obstacles do Orthopaedic Surgeons Face?
Description
In this presentation, Charlotte Lewis discusses the challenges and considerations surrounding the management of necrotising fasciitis, particularly in a district general hospital (DGH) setting. Unlike her colleagues who often handle this condition in acute surgical scenarios, Charlotte's focus lies in the realities faced by those working within a low socioeconomic demographic, where cases of necrotising fasciitis can be common. She opens by acknowledging her less frequent exposure to these cases but emphasizes their critical importance in medical training across multiple specialties, including Emergency Medicine and Orthopaedics.
Throughout her talk, Charlotte highlights the urgency of timely intervention in necrotising fasciitis to reduce mortality rates associated with delayed treatment. She cites literature that underscores the necessity of aggressive surgical management to improve outcomes. By surveying colleagues via a WhatsApp group, she shares anecdotal experiences and common fears associated with the diagnosis and treatment of this condition, which is rarely encountered in day-to-day practice for most surgeons.
Charlotte intricately discusses the decision-making processes involved in surgical consultations, noting the anxiety and hesitation that often accompanies management decisions. She emphasizes the importance of high suspicion levels for necrotising fasciitis and the requirement for senior-level reviews to ensure swift action.
Utilizing her research involving a small database of necrotising fasciitis cases from her hospital, Charlotte contrasts two distinct patient stories: one with a delayed diagnosis leading to a patient’s death and another with prompt surgical intervention that resulted in survival. She also introduces the 'finger sweep test,' a bedside evaluation technique that can aid in the diagnosis of necrotising fasciitis and improve management outcomes.
In conclusion, Charlotte advocates for shared responsibilities amongst surgical teams in making critical decisions and encourages the use of local microbiology resources for better-informed treatment approaches. She stresses the need for clear guidelines and educational efforts to bolster clinical competency in identifying and managing this life-threatening condition.