الفهرس 
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Abstract
NF is a rapidly progressive, soft-tissue infection characterized by extensive necrosis of the skin and subcutaneous tissue. In order to decrease the mortality rate of this life-threatening condition, rapid diagnosis, immediate surgical intervention, and broad-spectrum antibiotics are critical. However, other adjuvant therapies have been considered, such as hyperbaric oxygen and intravenous immunoglobulin.
NF remains one of the most devastating soft tissue infections in modern medicine. Many adjuncts have been described to help in the early recognition of the disease. What is needed in the management of necrotizing fasciitis is a clear and focused approach to the problem. Early surgical debridement decreases mortality and the aim is to diagnose the condition early, ideally within 24 h of admission. Depending on resources available, the managing team should exclude the diagnosis of necrotizing fasciitis with utmost urgency.
If MRI is needed, it should be performed within the next few hours. Certainly decision should not be delayed beyond 24 h while waiting for imaging to be available. Future developments of diagnostic adjuncts that can help in the identification of patients with necrotizing fasciitis should be focused on cheap and easily performed ‘bedside’ tests that are readily available.
The LRINEC score and transcutaneous tissue oxygen monitoring are examples of such adjuncts that were recently described but these have yet to show improved diagnostic yields or decreased mortality.
Ultimately, when doubts remain, often the best thing to do is to perform an early operative exploration.