Factors That Increase Risk of Necrotising Fasciitis
Necrotising fasciitis is an aggressive and potentially life-threatening infection of the deep tissues. It will cause tissue death and, if not treated in time, sepsis and organ failure.
Can anyone get necrotising fasciitis?
Yes, anyone can get necrotising fasciitis. People who are young, old, in poor health or in the best of health can get necrotising fasciitis. All it takes is for bacteria to get into the body's deep tissues.
Are there factors that increase the risk of getting necrotising fasciitis?
Yes, there are factors that increase the risk of getting necrotising fasciitis. So while theoretically anyone can get necrotising fasciitis, it is more likely to arise in people who have one or more of the following:
- Immuno-suppression
- Advanced age
- Peripheral vascular disease
- Obesity
- Recent history of skin trauma
- Intravenous drug use
- Diabetes mellitus
Why?
To explain why the aforementioned factors increase the risk of necrotising fasciitis, we look at them in turn, exploring why certain people are more vulnerable to tissue infection that others.
1. Immuno-suppression
Immunosuppression is when the immune system does not work properly. This can happen due to illness and/or medical treatment. Illnesses associated with immunosuppression in include HIV/AIDS, leukaemia, renal failure, lupus and diabetes. Chemotherapy is an example of a medical treatment that can suppress the immune system, while lifestyle factors such as malnutrition and chronic alcoholism can also be a contributing factor.
People who are immunosuppressed are far more susceptible to infection than others. This is because in a 'healthy' individual, the immune system will be activated when bad bacteria enter the body. It will set off a serious of responses to contain the infection and kill off the bacteria. Someone who is immunosuppressed will not have this ability. The immune system will not be strong enough to contain the infection and it will spread.
2. Advanced age
As we age, our immune system does not function quite as well as it once did. This ties into the previous point of immunosuppression. Unfortunately it is simply a natural occurrence of old age, even in those who remain active and healthy. Additionally, older people may have other medical conditions that exacerbate immunosuppression, even if it is a very low level of dysfunction that is not otherwise affecting their lives. This might include diabetes, arthritis and kidney dysfunction.
As described above, immunosuppression will increase the risk of bacterial infection. The immune system will not be able to fight it off and the bacteria will spread.
3. Peripheral vascular disease
Peripheral vascular disease is when there is a narrowing of the peripheral blood vessels (meaning those located outside of the brain and heart). Peripheral vascular disease is usually caused by a build-up of fatty deposits in the vessels, which in turn restricts the flow of blood through the vessels – particularly the legs. Blood carries oxygen to the tissues, so when the blood supply is impeded, the area will become deficient in oxygen. Blood also carries away waste products, so these will begin to build up.
The deficiency of blood and oxygen increases the risk of necrotising fasciitis. The tissue will already be unhealthy due to insufficient oxygen supply, and potentially may already be gangrenous. The introduction of bacteria will overwhelm the tissue, making it too difficult for the immune system to tackle.
4. Obesity
Obesity can narrow the blood vessels, having the same effects as peripheral vascular disease. Obesity can also lead to diabetes, which is another risk factor of necrotising fasciitis.
5. Recent history of skin trauma
For necrotising fasciitis to happen, the bacteria must somehow reach the body's deep tissues. This normally occurs when there is a break in the skin, allowing the bacteria access to the body. Therefore most people with necrotising fasciitis will recall a recent history of skin trauma, even if it is very tiny, such as a paper cut. Sometimes the skin trauma will be so insignificant the patient will not have been aware of it.
Skin trauma can refer to a vast array of things, including: surgical wound, paper cut, graze, burn, urinary catheter, intravenous drip, injection needle-wound and spider/insect bites. All these examples provide the bacteria with a chance to breach the natural defence of the skin.
6. Intravenous drug use
This follows on from the previous point: a needle-stick wound will injure the skin, giving the bacteria the opportunity to get inside the body. This means that necrotising fasciitis is more common amongst those who inject themselves regularly, such as people with type 1 diabetes and intravenous drug abusers.
7. Diabetes mellitus
Diabetes weakens the immune system, making it harder for the body to fight off the necrotising fasciitis infection. Furthermore, diabetes is associated with some of the other risk factors listed above. For example, people with type 1 diabetes often have to inject themselves with insulin, creating skin trauma through which the bacteria can enter. People with type 2 diabetes often suffer from obesity and related complications (such as peripheral vascular disease), leading to tissues deficient in oxygen.
What can be done to prevent necrotising fasciitis?
As with all bacterial infections, the best way to prevent necrotising fasciitis is with good hygiene. Someone may also be able to reduce their personal risk – for instance, by losing weight.
However, these steps will not always be sufficient to prevent necrotising fasciitis. It is a very aggressive infection and even the healthiest of people can succumb to necrotising fasciitis.
The best thing that can be done, therefore, is to diagnose and treat the condition early on. Having prompt treatment will minimise the extent of tissue death and prevent the life-threatening complications of organ failure and sepsis.
Failure to diagnose and treat necrotising fasciitis
If necrotising fasciitis is not treated quickly because doctors fail to diagnose the condition, there could be a case of medical negligence. If so, the patient or their family will be legally entitled to pursue a claim for compensation.
To find out more, please get in touch with us at Glynns Solicitors. We act for victims of medical error across England and Wales.
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To make a necrotising fasciitis medical negligence compensation claim, please get in touch with us today.
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