Necrotising fasciitis following a caesarean section

Abstract

Necrotising soft tissue infection was first documented by Fournier in 1883. Necrotising fasciitis is a rapidly progressive soft-tissue infection that involves the superficial and deep fascia, leading to thrombosis of the cutaneous vessels and gangrene of the underlying tissues (Hancevic et al., 1998). The lack of clear boundaries and late involvement of the overlying skin masks an early diagnosis. Risk factors include compromised immune state, diabetes mellitus, malnutrition, obesity, advancing age, renal impairment, malignancy, trauma (Rouse et al., 1982) and the use of steroids and NSAIDS (van Ammers et al., 1982) or presence of peripheral vascular disease. Although this is seen relatively commonly in general surgical practice, it is a rare complication in obstetrics and when it occurs it frequently presents as a fulminating disease.