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, 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, CHEESE 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, 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 Tank Top initiation of wound care despite the presence of infection.Therefore, NPWTi-d is effective for extensive and complicated wounds with infection after NF debridement.