Abstract：
In 2018 the first Dutch guideline on necrotizing soft tissue infections (NSTIs) was drafted. Its aim is to standardize the care of this disease in order to reduce variation, and thereby improve the quality of care. This guideline is a benchmark for all healthcare providers who deal with this devastating disease; it focuses on diagnostics, treatment options and organization of care. Given the low incidence, the complexity and the fulminant course of NSTIs, it is important to ensure continuous specialized care. Therefore it is recommended to make regional agreements about referral to specialized centres. Surgical exploration remains the gold standard for diagnosis. The empirical antibiotic regimen depends on if the onset of disease is community or nosocomial, and if its aetiology is a monomicrobial (type I) or a polymicrobial (type II). The guideline recommends that intravenous immunoglobulin (IVIg) therapy be started if gram staining reveals streptococci. IVIg must be discontinued if group-A streptococcus is excluded as a causative agent.
摘要：
2018年，荷兰起草了第一份关于坏死性软组织感染（NSTIs）的指南。其目的是规范这种疾病的护理，以减少变异，从而提高护理质量。本指南是所有处理这种毁灭性疾病的医疗保健提供者的基准；它侧重于诊断，治疗方案和护理组织。鉴于发病率低，NSTIs的复杂性和暴发性过程，重要的是要确保持续的专业护理。因此，建议就转介给专门中心达成区域协议。手术探查仍是诊断的金标准。经验性抗生素方案取决于疾病的发作是社区还是医院，如果它的病因学是单抗微生物（I型）或多微生物（II型）。该指南建议，如果革兰氏染色显示链球菌，则应开始静脉注射免疫球蛋白（IVIg）治疗。如果排除A组链球菌作为病原体，则必须停用IVIg。
