• Alexandre Boyer, Frederic Vargas, Fanny Coste, Elodie Saubusse, Yves Castaing, Georges Gbikpi-Benissan, Gilles Hilbert, and Didier Gruson.
• Medical Intensive Care Unit, Hôpital Pellegrin-Tripode, Place Amélie Raba Léon, 33076 Bordeaux cedex, France. alexandre.boyer@chu-bordeaux.fr
• Intensive Care Med. 2009 May 1;35(5):847-53.

PurposeSurgical treatment is crucial in the management of necrotizing soft tissue infections (NSTIs). The aim of this study was to determine the influence of surgical procedure timing on hospital mortality in severe NSTI.MethodsA retrospective study including 106 patients was conducted in a medical intensive care unit equipped with a hyperbaric chamber. Data regarding pre-existing conditions, intensive care and surgical management were included in a logistic regression model to determine independent factors associated with hospital mortality.ResultsOverall hospital mortality was 40.6%. In multivariate analysis, underlying cardiovascular disease, SAPS II, abdominoperineal compared to limb localization, time from the first signs to diagnosis <72 h, and time from diagnosis to surgical treatment >14 h in patients with septic shock were independently associated with hospital mortality.ConclusionIn patients with NSTI and septic shock, hospital mortality is influenced by the timing of surgical treatment.

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