Exploring Global Research Status and Trends in Necrotizing Fasciitis: A Bibliometric Analysis

Necrotizing fasciitis (NF) is a rare and extremely destructive soft tissue infection characterized by rapid progression and severe clinical manifestations. It can lead to serious complications and even death without prompt diagnosis and treatment. Despite advances in medical science, NF remains a major clinical challenge. This study analyzed 3381 NF-related research papers from the Web of Science Core Collection (WoSCC) database (1977-2024). We used text mining and bibliometric methods to research the number of papers, publishing institutions and countries, key authors, research hotspots, evolving trends, and other information, and to visualize the results. The analysis revealed a significant increase in publications, from fewer than 10 per year before 1990 to 228 in 2023. The United States, China, and Canada were the leading contributors, with the United States forming a core research network with Canada and the UK, while Chang Gung University in Taiwan, China, emerged as a key research hub in Asia. Early studies primarily focused on pathogens, whereas recent research has shifted toward treatment techniques and outcome prediction. High-frequency keywords like "mortality" and "diagnosis" reflect ongoing clinical challenges. Key unresolved issues include the diagnostic accuracy of the LRINEC score, optimal debridement timing, and health care disparities in resource-limited regions. The findings indicate a shift in NF research focus from etiology to clinical management and technological innovation. Future research should aim to refine diagnostic criteria, explore personalized treatments, and improve diagnostic capabilities in underserved areas. Interdisciplinary approaches, including information technology and materials science, are expected to drive NF research toward precision medicine.