A patient Came with Necrotising cellulitis after a hug bite on leg. The ideal initial management is
(D) Surgical exploration # Necrotizing fasciitis is a rapidly progressing bacterial infection of the soft tissue that destroys the subcutaneous fat and fascia. In most cases, the deep fascia and the muscle are spared from destruction by the infection, but myonecrosis can occur due to a compartment syndrome.> Many different bacteria can cause destruction of the soft tissue in a "flesh-eating" manner.> Proper diagnosis is critical in the treatment of necrotizing fasciitis, and in many cases, it is the major factor between life & death> One major clue that a soft-tissue infection is in fact necrotizing fasciitis is the failure of the infection to respond to antibiotic therapy within 24 to 48 hours.> Plain radiographs showing evidence of gas in the soft tissue is another key indicator, along with elevated muscle compartment pressure.> 5 A positive frozen-section biopsy specimen will also aid in proper diagnosis.> Once the diagnosis of necrotizing fasciitis is made, immediate debridement of necrotic tissue is called for. It is very common for a patient to undergo more than one debridement to make sure all of the necrotic tissue has been removed.> At the same time, aggressive antibiotic therapy with clindamycin should be started.> Wound should be examined daily, and the decision of whether or not to perform further debridement should be made> Amputation of an entire limb is sometimes performed, but this is only done as a life-saving measure.> Surgical debridement of the necrotic tissue is an essential part of the treatment of a necrotizing soft-tissue infection
MRI of leg
CT of leg
C-reactive protein estimation
Surgical exploration
Miscellaneous