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Table 1 Explanation of the steps to perform a SEFE examination

From: Sonographic exploration for fascial exploration (SEFE) in necrotizing fasciitis: a case report

SEFE examination

Step 1: Scan all fascial compartments (such as anterior, lateral, superficial posterior and deep posterior in the lower extremity) even if skin changes are not present

Step 2: Do you have BOTH diffuse subcutaneous thickening AND fascial fluid > 2 mm present? = If so, this is diagnostic for NF

Step 3: Additionally look for supporting, but not mandated findings such as subcutaneous air or abnormal architecture of the muscle tissue

Step 4: Mark area of US findings on patient skin and consult surgery for exploration