Modern Concepts of the Diagnosis and Treatment of Necrotizing Fasciitis—Review of 30 Cases

Necrotizing fasciitis (NF) is a rare, severe and often lethal soft-tissue infection. The objective of this retrospective study was to analyze the incidence, clinical outcomes of NF in our region compared to the global data and to review modern surgical techniques, in particular, negative pressure wound therapy (NPWT). The secondary aim was to assess whether LRINEC scoring had prognostic value. The study reviews 30 cases of histologically confirmed NF in the period of 2014 to 2023. We have evaluated demographic data, comorbidities, microbiological findings, surgical timing, and treatment outcomes. The incidence of NF in our medical center was elevated in comparison to other literature reports, likely due to improved diagnostics. The mortality rate was 3.3%, which was lower compared to the global average (20–40%), which may be related to early diagnosis and prompt surgical intervention in our center. Given the small sample, this finding must be interpreted descriptively. NPWT was used in approximately half of cases as a selective adjunct to wound care and was associated with favorable wound healing and functional outcomes. In more than half of the cases, the LRINEC score exceeded 8, but no significant correlation with mortality was observed. To our knowledge, this study proposes one of the more comprehensive studies analyzing NF in Central Europe. Early surgical exploration combined with NPWT was associated with excellent outcomes in our cohort and may provide a useful framework for further evaluation of NF management strategies.