- Design
- Single-centre retrospective case series
- Population
- 12 patients with periorbital necrotising fasciitis, 2014–2024
- Primary outcome
- Predictors of ICU stay ≥10 days; outcomes by surgical approach
- Effect
- Longer ICU stay with older age and LRINEC median 10 vs 4.5 (p=0.04)
A German tertiary eye department reviewed all 12 patients treated for periorbital necrotising fasciitis between 2014 and 2024 (median age 71). One died of multiorgan failure.
An intensive care stay of more than ten days was associated with older age and a higher LRINEC score from admission blood tests (median 10 vs 4.5). Patients having radical debridement had more extensive tissue involvement and longer ICU stays, and all had long-term complications, against 14% after tissue-sparing debridement, though that difference did not reach significance.
Twelve patients cannot settle the surgical question, and those treated radically had more extensive disease to begin with. The finding supports calculating LRINEC at admission to anticipate severity, but it cannot show whether tissue-sparing debridement is as safe as radical debridement. It was published in September 2026.
- Calculate the LRINEC score on admission for suspected periorbital necrotising fasciitis.
- Expect a longer ICU course in older patients and those with high LRINEC scores.
- The extent of debridement remains an urgent senior surgical decision; this series cannot settle it.
- Involve plastic surgery and intensive care early.
Why it matters
Eyelid preservation matters for the eye, but this series cannot show when less radical surgery is safe.
Don't overread it
Twelve patients, with sicker ones receiving radical surgery, cannot show which surgical approach is better.
The statistics, in plain English
With 12 patients, any comparison is fragile; a p-value of 0.08 for complications is not significant and the 14% vs 100% gap reflects very few people. The LRINEC score combines routine blood results to estimate the likelihood of necrotising infection.
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