Lower Extremity Necrotizing Fasciitis Managed With Negative Pressure Wound Therapy (NPWT) and Split-Thickness Skin Graft: A Case Report

Abstract

Introduction: Necrotizing fasciitis (NF) is an infection of the soft tissues (skin, subcutaneous tissue and fascia) that implies a rapidly and progressive evolution. In general, the treatment consists of stabilizing the patient, as well as the use of antibiotics that cover the most common agents, however, in most cases this is not useful without definitive management that consists of cleaning and surgical debridement. In addition to surgical lavage, adjunctive measures are often used in the treatment of complex wounds, such as vacuum-assisted closure (VAC) systems, also known as microdeformation wound therapy (MDWT) or negative pressure wound therapy (NPWT).

Objective: The objective is to present a successful case in the treatment of necrotizing fasciitis by negative pressure therapy with subsequent placement of grafts.

Case report: We present the case of a 50-year-old male patient with an extensive area of ​​necrosis in the anterior, posterior and external surface of the left pelvic limb secondary to a fall. Treatment consists of antibiotic and debridement of devitalized tissues, followed by VAC therapy to promote granulation of the tissues and prepare them for reconstruction. For its reconstruction, partial thickness grafts were used in the entire exposed area, with 100% integration of the tissues without functional limitation during its follow-up in the outpatient clinic.

Conclusion: The use of negative pressure therapy accelerates the wound granulation process, making it an option for patients with large areas of devitalized tissue, thus reducing their hospital stay and improving their quality of life.