Successful treatment of necrotizing fasciitis after rectal surgery with the application of a negative-pressure wound therapy: A case study

Abstract

Introduction: Necrotizing fasciitis (NF) is an aggressive soft tissue infection that involves the deep fasciaand is characterized by the extensive deterioration of the surrounding tissue. Immediate recognitionand aggressive treatment, including debridement and systemic antibiotics, are mandatory for the successfulmanagement of NF. Following radical debridement, closure of the remaining wound can posesignificant reconstructive challenges. Accumulating evidence indicates that application of negative-pressurewound therapy (NPWT) is useful in the treatment of patients with severe acute complex wounds,including NF.Case Presentation: A 58-year-old man who had undergone surgical resection for rectal carcinoma followedby chemo-radiation therapy developed NF of the pelvis and thigh three years after the surgicalprocedure. Following extensive debridement, a VAC system was applied to the large open wound andsuccessfully contributed to wound bed cleansing, which was followed by surgery for skin grafting.Conclusion: This case demonstrates the successful management of a complex and potentially lethalwound of the perineum to lower leg with debridement and skin grafting as well as with the applicationof the VAC system.