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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Tuesday, August 11, 2015

Fascitis necrotizante (STAFF US Exam)

Castleberg E, Jenson N y Dinh V A. West J Emerg Med. 2014 Feb; 15(1): 111–113.
"The early diagnosis of necrotizing fasciitis is often ambiguous and carries a high rate of morbidity and mortality if the diagnosis is missed. Although more sensitive, CT and MRI are time consuming and might not be readily available. Since a delay in treatment results in significantly increased morbidity and mortality; prompt diagnosis is crucial. The diagnostic ultrasound findings consistent with necrotizing fasciitis can be easily recalled by remembering to do an exam for STAFF. It warrants a special reminder, however, that ultrasound is not sensitive enough to exclude the diagnosis. Given clinical suspicion, and a negative ultrasound study, a more sensitive study such as CT, MRI or in advanced cases surgical exploration, is warranted.
While further study is required, this case supports that the early use of ultrasound in the form of a STAFF exam is an appropriate adjunct in those patients in whom there is a clinical suspicion of necrotizing fasciitis, with the goal of expediting operative debridement in much the same way as a focused assessment with sonography for trauma (FAST) exam is used to expedite laparotomy in unstable patients with abdominal trauma."

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