What is the appearance of initial necrosis in necrotizing fasciitis?

Updated: Oct 17, 2018
  • Author: Steven A Schulz, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

The initial necrosis appears as a massive undermining of the skin and subcutaneous layer. If the skin is open, gloved fingers can pass easily between the 2 layers and may reveal yellowish-green necrotic fascia. If the skin is unbroken, a scalpel incision will reveal it.

The normal skin and subcutaneous tissue become loosened from the rapidly spreading deeper necrotic fascia that is a great distance from the initiating wound. Fascial necrosis is typically more advanced than the appearance suggests.

Anesthesia in the involved region may be detected, and it usually is caused by thrombosis of the subcutaneous blood vessels, leading to necrosis of nerve fibers.


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