Surgery is not the first-line treatment option for patients with toxic shock syndrome(TSS). Surgical debridement is usually reserved for patients with either necrotizing fasciitis(NF), and patients with deep-seeded pyogenic infection. Urgent surgical debridement was recommended for all patients who develop NF earlier, but is under questioning nowadays.

Prompt, aggressive, immediate exploration and debridement of patients thought to have deep tissue localized infection was believed to be a surgical emergency ^[1]. Surgical exploration of the susceptible infected tissue may help with the early and definitive diagnosis of NF. In NF related TSS patients, infection usually is more extensive than is apparent from external examination. Although the necessity of surgical debridement, the recommendation of immediate radical excision of necrotic tissue in patients with streptococcal TSS NF is not supported by clinical studies and should be reconsidered as an emergency treatment in TSS management^[2].

Surgical debridement of body tissues should be considered in these patients:

• Localized source of infection is diagnosed
• Streptococcal NF-related TSS patients^{_Harrisons_Principles_of_Internal_Medicine,_18e_|_AccessMedicine_|_McGraw-Hill_Medical-3|[3]}

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