American Board of Family Medicine (ABFM) Practice Exam

In cases of necrotizing fasciitis, what is a critical therapeutic intervention?

1. Antibiotic therapy

2. Supportive care

3. Immediate surgical debridement

4. Wound dressing

The correct answer is: Immediate surgical debridement

In the management of necrotizing fasciitis, immediate surgical debridement is considered a critical therapeutic intervention. This condition is characterized by the rapid spread of infection within the fascial plane, leading to extensive tissue necrosis. Prompt surgical intervention is imperative to remove all necrotic and infected tissue, as this prevents the infection from spreading further and significantly improves the patient's chances of survival. Antibiotic therapy is essential in treating infections, but it can only work effectively when combined with the removal of infected tissues. Merely administering antibiotics without surgery does not adequately address the underlying problem, as the source of infection remains, continuing to produce toxins that can further harm the host. While supportive care is important for overall patient management, including fluid management and maintaining organ function, it does not address the urgent need to control the infection surgically. Wound dressing is also a supportive measure but does not play a role in the immediate control of the necrotizing infection. Thus, immediate surgical debridement is recognized as the cornerstone of treatment for necrotizing fasciitis.