Early identification of acute necrotizing fasciitis and timely limb-saving interventions in the emergency department: a systematic review

Mazi Mohammed Alanazi; Yousef Ibrahim Alshahwan; Maya Saeed Baselm; Anas Khalid Alghamdi; Osama Saud Alqhannam; Turki Fahad Al Saikhan; Noora Mohammed Aloudi; Abdulaziz Rishood Alqwizani; Abdulrahman Salman Almadani; Osamah Ahmed Alduaij; Yazed Ahmad Almahalawi

doi:10.24911/IJMDC.51-1763837300

2026, Vol: 10, Issue: 6

10 / 6Current Issue Online First Archive Aims and Scope Abstracting & Indexing Most Accessed Articles Most Downloaded Articles Most Cited Articles

« Previous Article

Review Article
Online Published: 04 Dec 2025

IJMDC. 2025; 9(11): 2992-2998

doi: 10.24911/IJMDC.51-1763837300

Early identification of acute necrotizing fasciitis and timely limb-saving interventions in the emergency department: a systematic review

Mazi Mohammed Alanazi, Yousef Ibrahim Alshahwan, Maya Saeed Baselm, Anas Khalid Alghamdi, Osama Saud Alqhannam, Turki Fahad Al Saikhan, Noora Mohammed Aloudi, Abdulaziz Rishood Alqwizani, Abdulrahman Salman Almadani, Osamah Ahmed Alduaij, Yazed Ahmad Almahalawi.

Abstract
Necrotizing fasciitis is a soft tissue infection in which early recognition and limb-saving surgery are critical, and the diagnosis in the emergency department (ED) is often delayed. In this systematic review, strategies for early identification and timing of limb-saving interventions were evaluated in patients with necrotizing fasciitis. PRISMA guidelines were followed, and electronic databases were searched for original studies conducted in emergency settings. Eligible studies reported clinical, laboratory, imaging, or biopsy-based approaches to early diagnosis and described the outcomes of limb-saving procedures. Data were qualitatively synthesized. Ten studies were included; the largest enrolled 1,506 surgically confirmed cases. Improved survival and limb preservation were found to be associated with high clinical suspicion, early risk stratification, and rapid access to debridement. Laboratory scores, LRINEC, were more useful for prediction than for ruling out disease. Pointof-care ultrasound and biopsy facilitated earlier operative decisions when presentation was ambiguous. The integration of clinical red flags, simple laboratory indices, bedside imaging, and structured risk scores shortens diagnostic delay in the ED and improves outcomes in necrotizing fasciitis.

Key words: Necrotizing fasciitis, emergency department, early diagnosis, amputation, LRINEC score, systematic review.

	ARTICLE TOOLS
	Abstract
	PDF Fulltext
	How to cite this article
	Citation Tools
	Related Records
	Articles by Mazi Mohammed Alanazi Articles by Yousef Ibrahim Alshahwan Articles by Maya Saeed Baselm Articles by Anas Khalid Alghamdi Articles by Osama Saud Alqhannam Articles by Turki Fahad Al Saikhan Articles by Noora Mohammed Aloudi Articles by Abdulaziz Rishood Alqwizani Articles by Abdulrahman Salman Almadani Articles by Osamah Ahmed Alduaij Articles by Yazed Ahmad Almahalawi
	on Google
	on Google Scholar

How to Cite this Article

Pubmed Style

Alanazi MM, Alshahwan YI, Baselm MS, Alghamdi AK, Alqhannam OS, Saikhan TFA, Aloudi NM, Alqwizani AR, Almadani AS, Alduaij OA, Almahalawi YA. Early identification of acute necrotizing fasciitis and timely limb-saving interventions in the emergency department: a systematic review. IJMDC. 2025; 9(11): 2992-2998. doi:10.24911/IJMDC.51-1763837300

Web Style

Alanazi MM, Alshahwan YI, Baselm MS, Alghamdi AK, Alqhannam OS, Saikhan TFA, Aloudi NM, Alqwizani AR, Almadani AS, Alduaij OA, Almahalawi YA. Early identification of acute necrotizing fasciitis and timely limb-saving interventions in the emergency department: a systematic review. https://www.ijmdc.com/?mno=298667 [Access: June 23, 2026]. doi:10.24911/IJMDC.51-1763837300

AMA (American Medical Association) Style

Alanazi MM, Alshahwan YI, Baselm MS, Alghamdi AK, Alqhannam OS, Saikhan TFA, Aloudi NM, Alqwizani AR, Almadani AS, Alduaij OA, Almahalawi YA. Early identification of acute necrotizing fasciitis and timely limb-saving interventions in the emergency department: a systematic review. IJMDC. 2025; 9(11): 2992-2998. doi:10.24911/IJMDC.51-1763837300

Vancouver/ICMJE Style

Alanazi MM, Alshahwan YI, Baselm MS, Alghamdi AK, Alqhannam OS, Saikhan TFA, Aloudi NM, Alqwizani AR, Almadani AS, Alduaij OA, Almahalawi YA. Early identification of acute necrotizing fasciitis and timely limb-saving interventions in the emergency department: a systematic review. IJMDC. (2025), [cited June 23, 2026]; 9(11): 2992-2998. doi:10.24911/IJMDC.51-1763837300

Harvard Style

Alanazi, M. M., Alshahwan, . Y. I., Baselm, . M. S., Alghamdi, . A. K., Alqhannam, . O. S., Saikhan, . T. F. A., Aloudi, . N. M., Alqwizani, . A. R., Almadani, . A. S., Alduaij, . O. A. & Almahalawi, . Y. A. (2025) Early identification of acute necrotizing fasciitis and timely limb-saving interventions in the emergency department: a systematic review. IJMDC, 9 (11), 2992-2998. doi:10.24911/IJMDC.51-1763837300

Turabian Style

Alanazi, Mazi Mohammed, Yousef Ibrahim Alshahwan, Maya Saeed Baselm, Anas Khalid Alghamdi, Osama Saud Alqhannam, Turki Fahad Al Saikhan, Noora Mohammed Aloudi, Abdulaziz Rishood Alqwizani, Abdulrahman Salman Almadani, Osamah Ahmed Alduaij, and Yazed Ahmad Almahalawi. 2025. Early identification of acute necrotizing fasciitis and timely limb-saving interventions in the emergency department: a systematic review. International Journal of Medicine in Developing Countries, 9 (11), 2992-2998. doi:10.24911/IJMDC.51-1763837300

Chicago Style

Alanazi, Mazi Mohammed, Yousef Ibrahim Alshahwan, Maya Saeed Baselm, Anas Khalid Alghamdi, Osama Saud Alqhannam, Turki Fahad Al Saikhan, Noora Mohammed Aloudi, Abdulaziz Rishood Alqwizani, Abdulrahman Salman Almadani, Osamah Ahmed Alduaij, and Yazed Ahmad Almahalawi. "Early identification of acute necrotizing fasciitis and timely limb-saving interventions in the emergency department: a systematic review." International Journal of Medicine in Developing Countries 9 (2025), 2992-2998. doi:10.24911/IJMDC.51-1763837300

MLA (The Modern Language Association) Style

Alanazi, Mazi Mohammed, Yousef Ibrahim Alshahwan, Maya Saeed Baselm, Anas Khalid Alghamdi, Osama Saud Alqhannam, Turki Fahad Al Saikhan, Noora Mohammed Aloudi, Abdulaziz Rishood Alqwizani, Abdulrahman Salman Almadani, Osamah Ahmed Alduaij, and Yazed Ahmad Almahalawi. "Early identification of acute necrotizing fasciitis and timely limb-saving interventions in the emergency department: a systematic review." International Journal of Medicine in Developing Countries 9.11 (2025), 2992-2998. Print. doi:10.24911/IJMDC.51-1763837300

APA (American Psychological Association) Style

Alanazi, M. M., Alshahwan, . Y. I., Baselm, . M. S., Alghamdi, . A. K., Alqhannam, . O. S., Saikhan, . T. F. A., Aloudi, . N. M., Alqwizani, . A. R., Almadani, . A. S., Alduaij, . O. A. & Almahalawi, . Y. A. (2025) Early identification of acute necrotizing fasciitis and timely limb-saving interventions in the emergency department: a systematic review. International Journal of Medicine in Developing Countries, 9 (11), 2992-2998. doi:10.24911/IJMDC.51-1763837300

Most Viewed Articles

Most Accessed Articles

Marginal adaptation of fixed prosthodontics
Shahad Mohammed Halawani, Sahar Amer Al-Harbi
IJMDC. 2017; 1(2): 78-84
» Abstract » doi: 10.24911/IJMDC.1.2.7

Parasites in central nervous system
Amal Ahmed Mohamed, Asmaa Mohamed Mansour
IJMDC. 2017; 1(2): 72-77
» Abstract » doi: 10.24911/IJMDC.1.2.6

Non-diabetic retinopathy: a case report
Hassan F. Alkwikbi, Nabil Mamon Abdelfattah, Haithem Mamon Abdelfattah
IJMDC. 2017; 1(1): 33-37
» Abstract » doi: 10.24911/IJMDC.1.1.6

Vitamin D deficiency among high school female students in Riyadh
Sahar Mohsen Aldhafeeri, Fatemah Ibraheem Alrawaji, Abrar Mubarak Algharbi, Alanoud Abdullah Alhessan, Ayat Sami Qabaja, Ghaleah Abdulaziz Alnassar, Ghaliah Ofayn Alsulami, Mashael Belal Alrubaian, Norah Abdulaziz Alhatim, Salehah Salih Alotaibi, Zahra Ali Alkhamees
IJMDC. 2017; 1(1): 18-23
» Abstract » doi: 10.24911/IJMDC.1.1.4

Prognosis of chronic complications of diabetes mellitus (DM) after multiple events of diabetic ketoacidosis (DKA)
Baraa Faiez Rajab, Anwar Essa Alamrim, Ali Essa Alamri
IJMDC. 2019; 3(5): 474-479
» Abstract » doi: 10.24911/IJMDC.51-1546551993

Most Downloaded

Top Downloaded Articles

Perception and attitude of medical students towards trauma and orthopedic teaching: a cross-sectional study
Nawaf Hameed Almohammadi, Faisal Ali Almesned, Atif Omar Alhawsah, Sami Aoudah Alahmari, Madloul Jassim Alshammari, Hamad Ali Alkhunayfir
IJMDC. 2019; 3(6): 503-508
» Abstract » doi: 10.24911/IJMDC.51-1548706801

Anti-IL-17 markedly inhibited the in vitro granuloma induced by Schistosoma mansoni soluble egg antigen.
Asmaa Ezz, Irene S. Gmail, Fatma Elzahraa H. Salem, Rabab Salama, Soad Nady
IJMDC. 2018; 2(January 2018): 38-46
» Abstract » doi: 10.24911/IJMDC.2.1.7

Antibiotic Resistance Crisis
Nuha Saad Mobarki, Buthaina Abdullah Almerabi, Ahmad Hattan Hattan
IJMDC. 2019; 3(6): 561-564
» Abstract » doi: 10.24911/IJMDC.51-1549060699

Marginal adaptation of fixed prosthodontics
Shahad Mohammed Halawani, Sahar Amer Al-Harbi
IJMDC. 2017; 1(2): 78-84
» Abstract » doi: 10.24911/IJMDC.1.2.7

Most Cited Articles

Most Cited Articles

Antibiotic Resistance Crisis
Nuha Saad Mobarki, Buthaina Abdullah Almerabi, Ahmad Hattan Hattan
IJMDC. 2019; 3(6): 561-564
» Abstract » doi: 10.24911/IJMDC.51-1549060699
Cited : 34 times [Click to see citing articles]

Prevalence of depression, anxiety and stress among diabetes mellitus patients in Arar, Northern Saudi Arabia
AMohammed Elamin Mukrim, Nujud Muteb D. Alshammari, Wurud Muteb D. Alshammari, Maali Subhi T. Alshammari, Yousef Nasif R. Alshammari, Abdulaziz Sael M. Alshammari, Maisa Hamad F. Alanazi, Abdulelah Abdulrhman F. Alzammam, Muharib Mana M. Alshammari, Slwa Khaled Abu Asyah, Aseel Jamal Alzuhayri, Mushref Saeid Alshammari
IJMDC. 2019; 3(3): 229-233
» Abstract » doi: 10.24911/IJMDC.51-1542576396
Cited : 8 times [Click to see citing articles]

Knowledge, attitude, and practice of breast self-examination toward breast cancer among female students at King Saud University in Riyadh, Saudi Arabia
Abdullah Nasser Alomair, Dania Ghazi Felemban, Mohannad Sami Felemban, Jameel Abdullah Awadain, Ammar Saud Altowairqi, Nawaf Fawzan Alfawzan, Fatimah Mohammed Almazayen, Abdulrahman Jalwi Korkoman, Nawaf Saad Alrusayyis
IJMDC. 2020; 4(2): 429-434
» Abstract » doi: 10.24911/IJMDC.51-1576668182
Cited : 8 times [Click to see citing articles]

Population awareness about rheumatoid arthritis in Jazan region, Saudi Arabia
Ahmad Ali Hazzazi, Mohssen Hassen Ageeli, Ahmed Ali Muyidi, Abdulaziz Mohammad Abulgasim, Abdullah Ahmad Yateemi, Nabil Alhakami
IJMDC. 2020; 4(3): 668-675
» Abstract » doi: 10.24911/IJMDC.51-1576010943
Cited : 4 times [Click to see citing articles]

Prevalence and factors associated with depression among health care workers in National Guard Hospital in Riyadh, KSA
Noor Mohammad AlFahhad
IJMDC. 2018; 2(September 2018): 92-96
» Abstract » doi: 10.24911/IJMDC.51-1526306040
Cited : 4 times [Click to see citing articles]

Effect of inter-pregnancy interval on pregnancy outcome: a prospective study at Fayoum, Egypt
Eman M. Mahfouz, Naglaa A. El-Sherbiny, Wafaa Y. Abdel Wahed, Nashwa S. Hamed
IJMDC. 2018; 2(May 2018): 38-44
» Abstract » doi: 10.24911/IJMDC.51-1520268317
Cited : 4 times [Click to see citing articles]

Diabetic neuropathy in Saudi Arabia: a comprehensive review for further actions
Mohammad Mater Aljohani, Amjad Taj Karam, Ayman Abdulaziz Alamri, Mohammed Hamed Manfaloti, Hussain Abbas Alnakhli, Hatem Ahmed Shaqroon
IJMDC. 2020; 4(11): 2008-2013
» Abstract » doi: 10.24911/IJMDC.51-1601343665
Cited : 4 times [Click to see citing articles]

Public Awareness of coronary artery disease risk factors in Qassim, Saudi Arabia: a cross-sectional study
Abdullah Muzil Albadrani, Saleh Sulaiman Al-Ajlan, Abdullah Saer E. Alharbi, Abdulelah Saud Alharbi, Saif Mohammed Radhi Alharbi
IJMDC. 2020; 4(3): 593-599
» Abstract » doi: 10.24911/IJMDC.51-1572217065
Cited : 4 times [Click to see citing articles]

Ischemic stroke: prevalence of modifiable risk factors in the Saudi population
Muhannad Noor Alharbi, Atheer Khalid Alharbi, Mousa Atqan Alamri, Abdulmalik Ayedh Saad Alharthi, Abdulrahman Moneer Alqerafi, Mohamed Noor Alharbi
IJMDC. 2019; 3(7): 601-603
» Abstract » doi: 10.24911/IJMDC.51-1548376707
Cited : 3 times [Click to see citing articles]

Prevalence and risk factors for diabetic nephropathy in type 2 diabetic patients, Taif City, Saudi Arabia
Basel Saad Alzahrani, Turki Hamdan Alzidani, Abdullah Mohammed Alturkistani, Hani Abozaid
IJMDC. 2019; 3(2): 167-172
» Abstract » doi: 10.24911/IJMDC.51-1541336905
Cited : 3 times [Click to see citing articles]

Assessment of knowledge and awareness regarding thyroid disorders among Saudi people
Assem Saleh Ali Almuzaini , Bayan ahmad I Alshareef , Sundos Hamoud O Alghamdi, Ayman Adnan Munshy, Abdulmajeed Khalid M. Aljarallah, Saud Abdulaziz A Salman, Khalid Saud Alroqi, Reem Dayel A Alkhaldi
IJMDC. 2019; 3(12): 1070-1076
» Abstract » doi: 10.24911/IJMDC.51-1568037206
Cited : 3 times [Click to see citing articles]

Assessment of knowledge, attitude, and practice in relation to use of isotretinoin among Al-Madinah population, Saudi Arabia
Amr Molla, Hassan Abdullah Alrizqi, Emtinan Mohammed Salem Alruhaili, Saad Abdullah Alrizqi, Arwa Musaad Alsubhi
IJMDC. 2020; 4(1): 107-112
» Abstract » doi: 10.24911/IJMDC.51-1571752077
Cited : 3 times [Click to see citing articles]

Ethical considerations in doctors & pharmaceutical industries relationship: a narrative review
Mohammed Saud Almasri, Yousef Rafat Bukhari, Bandar Saleh Alzuair, Mansour Khalid Almadi, Amro Khalid Bin Abdulrahman
IJMDC. 2020; 4(1): 244-252
» Abstract » doi: 10.24911/IJMDC.51-1572794591
Cited : 3 times [Click to see citing articles]

Assessment of the knowledge of pregnant women regarding the effects of GDM on mothers and neonates at a Maternal and Children hospital in Najran, Saudi Arabia
Amina Abdo Salhi, Medical Intern, Majed Saeed Alshahrani, Maram Mohammed Alyamin, Waad Ahmed Hamdi, Sarah Raja Alyami, Albatool Saleh Almagbool, Nujoud Hamad Almoqati, Seham Hamad Almoqati, Esra'a Amer Nasser Al-Saaed, Hessa Salem Al Habes, Batool Mubarak Abdullah Alwdei, Ahlam Yhya Saeed Alyami, Wesal Ahmed Alassiri
IJMDC. 2019; 3(4): 370-375
» Abstract » doi: 10.24911/IJMDC.51-1545817090
Cited : 3 times [Click to see citing articles]

Awareness of the Saudi population about the role of the Emergency Rooms
Zead Ibrahim A. Alhussain, Mohammed Ali A. Alghamdi, Rana Mohamed Ahmed, Abdullah Yahya Aldhban, Abdulrahman Ali Alghamdi, Naif Shalan J. Alalyani
IJMDC. 2019; 3(11): 957-962
» Abstract » doi: 10.24911/IJMDC.51-1568717752
Cited : 3 times [Click to see citing articles]

About International Journal of Medicine in Developing Countries

Contact Information

How to cite this article