Efficacy analysis of early incision and drainage on necrotizing fasciitis, a retrospective study

Necrotizing fasciitis is a life-threatening infectious disease, and extensive debridement, as the primary surgical approach, poses significant risks for advanced-stage patients. Early incision and drainage is a common treatment for soft tissue infections, while its efficacy as a temporizing strategy in necrotizing fasciitis patients remains unclear. This study included 116 necrotizing fasciitis patients who underwent surgical treatment at Zhongda Hospital from 1 Jan 2015 to 28 Feb 2025. Based on their initial surgical approach, patients were divided into the incision and drainage group (48 cases) and the extensive debridement group (68 cases). We collected the demographic data, clinical manifestations, treatment details, and outcomes of all patients, and analyzed through t-tests, Mann-Whitney U tests, and chi-square tests. Binary logistic regression was conducted to assess the outcomes of amputation and mortality rate. In this study, more patients in the I&D group were man (P = 0.031). A higher proportion of patients in the I&D group presented with anemia (P = 0.035), hypoalbuminemia (P = 0.030), abnormal serum creatinine level(P = 0.029), and were at advanced stage of NF(P = 0.031) on admission. The amputation rate was significantly reduced in the I&D group (P = 0.021). After adjusting for multiple confounders, both early I&D (Amputation: aOR = 0.107, 95%CI: 0.022–0.511. Mortality rate: aOR = 0.172, 95%CI: 0.032–0.924.) and higher albumin level (Amputation: aOR = 0.838, 95%CI: 0.724–0.97. Mortality rate: aOR = 0.71, 95%CI: 0.599–0.902.) were associated with a significant reduction in the risks of amputation and mortality rate in NF patients. Early incision and drainage was associated with a lower risk of amputation and mortality in necrotizing fasciitis patients, offering an effective temporizing strategy to improve prognosis, particularly for those with poor nutritional status.