Finger test for Necrotizing Fascitis

Synonyms: Finger sweep test

Finger test can be performed under Local anesthesia or General anesthesia in:

1. Emergency department
2. Bedside in wards
3. Operation theaters

Procedure:

1. Area is infiltrated with local anesthetic
2. A 2 cm test incision down to fascia is made in the suspected area
3. The tissues are visually examined for:
   • The absence bleeding
   • Dirty ‘dishwater’ coloured fluid
   • Discolouration of the fat
   • Non-contracting muscles
4. A rapid finger sweep at the level of the fascia is then carried out. If the tissues dissect with minimal resistance this again favours the diagnosis of necrotizing fascitis.
5. Fluid and tissue samples can also be obtained at this stage for microbiological analysis.

Reference: Albadri Z, Salman K. Necrotizing fasciitis of the finger. IDCases. 2019 May 10;17:e00560. doi: 10.1016/j.idcr.2019.e00560. PMID: 31384560; PMCID: PMC6667696.