Procalcitonin Ratio of Post-Operative Day 1 and Day 2 Procalcitonin Values to Predict the Surgical Outcome in Severe Necrotizing Soft Tissue Infections

Harshavardhan N1*, Vijaya Kumar K2 and Mohammed Imaduddin3

1Department of CTVS, Sri Sathya Sai Institute of Higher Medical Sciences, India
2Department of General Surgery, Osmania Medical College, India
3Department of Surgical Oncology, All India Institute of Medical Science, India

^*Correspondance to: Niraghatam Harshavardhan 

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Abstract:

Introduction: Necrotizing soft tissue infections are fulminant and life threatening bacterial infections
which affects the fascia and subcutaneous tissue. The progression of disease is in hours and early
diagnosis is difficult as the infection advances below the surface and cutaneous manifestations do
not match the severity of the underlying disease. In this study we aim to calculate an optimum cut
off Procalcitonin (PCT) ratio which determines the success and failure of surgical treatment offered.
Methods: Study group comprised of 38 patients with various forms of Necrotizing Soft Tissue
Infections (NSTIs) who were offered major surgical debridement within the 1st 24 h under
anesthesia. Intra operative specimens were sent for microbial culture and antibiotic sensitivity and
for histopathological examination.
PCT levels on post-surgery day 1 and day 2 were measured after every major surgical debridement.
Based on these values a PCT ratio value day 1/day 2 was developed which is used to assess the
progress of disease and the adequacy of the 1st debridement and to facilitate the decision process of
re-operations and major amputations.
Results and Conclusion: The calculated optimal PCT cut off ratio, which was 1.19 in our study, is
able to distinguish between the successful and unsuccessful surgical eradication of the infection in
NSTI’s with a high sensitivity of 91% and specificity of 97%.

Keywords:

Severe necrotizing soft tissue infections; Optimal cutoff procalcitonin ratio; Major surgical debridement; Focus eradication

Cite the Article:

Harshavardhan N, Vijaya Kumar K, Imaduddin M. Procalcitonin Ratio of Post-Operative Day 1 and Day 2 Procalcitonin Values to Predict the Surgical Outcome in Severe Necrotizing Soft Tissue Infections. World J Surg Surgical Res. 2020; 3: 1267..