Tess M Wemeijer*, Marianne RF Bosscher and BP Bertelink
Background: Necrotizing fasciitis is a rare but lifethreatening infection, frequently caused by group A streptococcus (GAS), which requires timely diagnosis and urgent medical treatment. Surgical intervention consists of removing all the affected tissue, as well as preservation of skin tissue to prevent excessive mutilation. In this case report we describe a method to minimalize the mutilation by using external fixation material, with favourable outcome.
Case description: A 33-year old man with necrotizing fasciitis of his left arm, caused by group A streptococcus (GAS), was treated successfully with the use of external fixation material to open up all the muscle compartments while remaining a sufficient amount of skin for secondary skin closure. When sufficient control of the infection was accomplished, tie-wraps in combination with vacuum therapy were applied to establish secondary skin closure. By using the external fixation for preservation of the skin, the amount of scar tissue was minimal when considering the severity of the primary infection.
Conclusion: In case of necrotizing fasciitis to an extremity, the use of external fixation material with vacuum therapy could enhance the treatment, preserving sufficient skin for secondary wound closure and restoration of limb function. In this way, the morbidity of necrotizing fasciitis can be minimalized.