Journal of plastic, reconstructive & aesthetic surgery : JPRAS
August 12, 2026 · via Europe PMC
Epidemiology of lower limb necrotising fasciitis in England: A national study (2002-2022).
Carolan D, Hennessy C, Browne R, Abram SGF, Dolan R, Wormald JCR.
AI summary — for doctors, generated from the abstract only
Lower limb necrotising fasciitis in England has become about seven times more frequent over 20 years and still carries high mortality and amputation rates.
What was studied
Retrospective national Hospital Episode Statistics analysis of 2,512 patients with lower limb necrotising fasciitis from 2002 to 2022.
Key findings
- Incidence rose from 0.1 to 0.8 per 100,000
- Over a third were from the most deprived quintile, and 55% had severe comorbidity
- More than 17% required amputation; mortality was 12.6% at 30 days and 24% at 1 year
Clinical relevance
Reinforces the need for early recognition and aggressive treatment of a surgical emergency.
Who should care
Limitations
Administrative coding may misclassify cases, and the rise could reflect better reporting.
Maintain a high index of suspicion, especially in comorbid and deprived patients, and act urgently.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Aim
Necrotising fasciitis is a surgical emergency, characterised by fulminant infection of the superficial fascia, with progression to systemic toxicity, septic shock and death if not addressed urgently. The lower limb is most commonly affected. Treatment involves resuscitation, urgent surgical debridement and broad-spectrum antimicrobials. we describe the epidemiology of lower limb necrotising fasciitis in England, over a 20-year period.
Methods
This retrospective population-based cohort study analysed 2002-2022 Hospital Episode Statistics data on lower limb necrotising fasciitis in England. Patients were identified using ICD-10 and OPCS-4 codes. Demographics, comorbidities, outcomes and deprivation indices were assessed. We employed population-level analysis of admissions, complications and mortality over two decades.
Results
Between 2002 and 2022, 2512 people were diagnosed with lower limb necrotising fasciitis. The incidence increased seven-fold, ranging from 0.1 to 0.8 per 100,000 individuals, with most cases diagnosed in patients over the age of 40 years. Over one-third of cases occurred in patients from the most socially deprived quintile. Fifty-five percent of the patients had severe comorbidities. A diagnosis of necrotising fasciitis was associated with substantial morbidity. Over 17% required limb amputation. Thirty-day mortality was 12.6% that rose to 17.4% at 90 days.
Conclusions
The incidence of necrotising fasciitis appears to be increasing. This may coincide with improved reporting, establishment of registry databases or an ageing population. Mortality remains high, with a 1-year mortality of 24%. Cases were more frequently observed in socially deprived groups. Public health strategies should consider socioeconomic disparities to improve access and outcomes.
DOI
10.1016/j.bjps.2026.08.012
PMID
42777621
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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