Abstract

Sixteen patients with necrotizing fasciitis of the perineum were treated at the Seoul National University Hospital from 1980 to 1988. Necrotizing fasciitis(N.F) occured predominantly in males(N : F= 14: 2), and the age of patients was even in distribution. These infections were caused by illicit injection for hemorrhoids, postoperative complica-tion, perianal abscess, fish bone impaction, bladder rupture due to traffic accident, and spontaneously in a half of patients. Necrotizing fasciitis is a rare disease that involves both superfical and deep fascia. It begins with fascial necrosis at onset and rapidly progresses to surrounding fascial planes, eventually involving overlying skin and underlying muscle. Escherichia coli was the most predominant organism cultured from the wounds in 12 patients. Other organism cultured were Pseudomonas enterococcus, streptococcus in orders of decreasing frequency. The accompanying disease was most commonly diabetes mellitus but perianal diseases such hemorrhoids and anal fistulas also occurred Its hospital course was quite long(mean : 60. 9 days) and showed high morbidity(6). The most definitive treatment was multiple incision and complete surgical removal of all necrotic tissue until the normal plane was reached. Reconstructive procedures such as skin graft and musculo cutaneous flap were necessary for 11 patients. None of the 16 patients died of the disease.