Necrotizing fasciitis wound after debridement could be successfully treated with negative-pressure wound therapy with instillation and dwelling: A case report

Necrotizing fasciitis wound after debridement could be successfully treated with negative-pressure wound therapy with instillation and dwelling: A case report

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Background: Necrotizing fasciitis (NF) is associated with a high mortality rate.Adequate incision and drainage and repeated debridement are necessary for NF management.After drainage, Air Conditioner Inlet Valve daily local irrigation should be performed.

Case presentation: A 72-year-old male patient complained of left lower quadrant pain.Computed tomography revealed a 7 cm mass in the descending colon, with retroperitoneal penetration.Hence, he underwent emergency surgery.

The left abdomen was widely incised, and a transverse colostomy was performed for local wound control.Daily debridement of necrotic tissue and wound irrigation were continued.On postoperative day 48, the wound was extensive and complex and obtained a positive bacterial culture.

Subsequently, we began a negative-pressure wound therapy with instillation and dwelling (NPWTi-d), which was very effective for extensive and complicated wounds with infection.Thereafter, CALENDULA SHAMPOO a split-thickness skin was grafted, and the skin graft survived well.Ultimately, the wound successfully closed.

Conclusions: NPWT is contraindicated for infected wounds, and an infection control period is required.However, NPWTi-d enables early initiation of wound care despite the presence of infection.Therefore, NPWTi-d is effective for extensive and complicated wounds with infection after NF debridement.