Surgical treatment is crucial in the management of necrotizing soft tissue infections (NSTIs). The aim of this study was to determine the influence of surgical procedure timing on hospital mortality in severe NSTI. A retrospective study including 106 patients was conducted in a medical intensive care unit equipped with a hyperbaric chamber. Data regarding pre-existing conditions, intensive care and surgical management were included in a logistic regression model to determine independent factors associated with hospital mortality. Overall hospital mortality was 40.6%. In multivariate analysis, underlying cardiovascular disease, SAPS II, abdominoperineal compared to limb localization, time from the first signs to diagnosis <72 h, and time from diagnosis to surgical treatment >14 h in patients with septic shock were independently associated with hospital mortality. In patients with NSTI and septic shock, hospital mortality is influenced by the timing of surgical treatment.

Boyer, Vargas, Coste, Saubusse, Castaing, Gbikpi-Benissan, Hilbert, Gruson, (2009). Influence of surgical treatment timing on mortality from necrotizing soft tissue infections requiring intensive care management. Intensive care medicine, 2009 May;35(5):847-53. https://www.ncbi.nlm.nih.gov/pubmed/19099288