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The Danger of Open Wounds

Many athletes looking for an extra sense of thrill participate in extreme sports, such as obstacle course running, adventure racing, or zip lining. These sports and activities typically take place outdoors and are subject to nature’s elements. A hidden danger that often can be overlooked is the risk of serious skin and flesh infection, particularly if an athlete is exposed to warm or bacteria-laden water.

Necrotizing Fasciitis

Any type of bacterial infection that affects the soft tissue (or fascia) is commonly known as necrotizing fasciitis. This occurs when an open wound comes in direct contact with harmful bacteria, often found in still or dirty water. Open wounds can be caused by simple cuts, contusions, abrasions, and even insect bites.

The harmful bacteria will typically cause the skin cells and soft tissue to die (necrotize), and in serious cases may cause further complications that can lead to serious illness, amputation, and even death. In athletes that spend their time outdoors and around lakes, ponds, and rivers, extra precaution must be taken to ensure that the skin surface is free from any pathways for bacteria to take hold.

Signs and Symptoms

Specific signs and symptoms may vary depending on the severity of the infection, but may include:

  • Small, red, painful lump or bump on skin
  • Skin that breaks open and oozes fluid
  • Fever, sweating, chills, or nausea
  • Dizziness and weakness
  • Shock
  • Swollen tissue that is hot to the touch and very painful
  • Rapid heart rate
  • Sunburn-like rash
  • Large dark boil-like blisters

In serious cases, the body will ultimately go into toxic shock, and internal organs will shut down. This is why early detection of these signs and symptoms is vital.


Due to its spontaneous nature, there is no definitive prevention method. Rather, there are many steps an athlete can take to help minimize the risk of necrotizing fasciitis. The most important step is to keep skin clean and intact. Even with small cuts, be sure to clean thoroughly, apply an antibiotic ointment, and keep covered. Athletes with open cuts or wounds should try to avoid direct contact with individuals who have a strep infection.


The key to effective treatment is timeliness and early detection. What many athletes may brush off as a simple rash or irritation may prove to be much more serious. In the majority of cases, this disease is typically not serious and will resolve with cleaning, bandaging, and proper wound care. In more serious cases, treatment steps may include:

  • Diagnostic testing, such as x-rays, CT scans, or MRI
  • Intravenous antibiotics
  • Surgery to remove dead tissue
  • Special antibody medicines to help fight infection
  • 100 percent oxygen at high pressure
  • Skin grafts after infection subsides
  • Amputation to decrease spread

If left untreated and ignored, necrotizing fasciitis can lead to several serious complications and even death. However, with the right precautions and considerations, athletes can help decrease the risk of contracting skins and flesh infections, and stay safe in the great outdoors.

If you suspect any type of skin-related bacterial infection, please contact your family physician or a dermatologist for proper diagnosis and treatment. Or call 911 if your case is an emergency.

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