Free tissue transfer for necrotizing fasciitis reconstruction: A case series

Gawaziuk, Justin P.; Liu, Tianyi; Sigurdson, Leif; Buchel, Edward W.; Hayakawa, Thomas Edward Jo; Shiga, Sarah; Logsetty, Sarvesh

doi:10.1016/j.burns.2017.04.007

Cited by 16 publications

(27 citation statements)

References 28 publications

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“…Gawaziuk et al [17] also previously reported on a case series of free flap transfer after NF and was able to show no flap failures and a minimal complication rate. Beier et al [18] were also able to demonstrate a thoracic reconstruction using a bilateral free pre-expanded tensor fascia latae (TFL) flap in an 8-year-old child.…”

Section: Discussionmentioning

confidence: 74%

Defect reconstruction of the trochanter major after necrotizing fasciitis and multiple operations using an arteriovenous loop and latissimus dorsi free flap

Arkudas¹,

Regus²,

Meyer³

et al. 2018

PAR

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Necrotizing fasciitis (NF) is a severe soft tissue infection which has to be treated with a radical debridement as the key element. In the further course often large tissue defects occur, so that a long-term stable defect reconstruction plays a crucial role after any successful debridement. The reconstruction can include split skin grafting or local and free flaps. Here we present a case of a 41-year-old male patient with a NF in the trochanter major region after spondylodesis and spinal cord stimulation (SCS) device implantation. After multiple operations including local and free flaps we performed a defect reconstruction using an arteriovenous (AV) loop and subsequent free latissimus dorsi transplantation leading to no further operations. This complex reconstruction can be considered as the final stage of any reconstruction latter.

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Section: Discussionmentioning

confidence: 74%

Defect reconstruction of the trochanter major after necrotizing fasciitis and multiple operations using an arteriovenous loop and latissimus dorsi free flap

Arkudas¹,

Regus²,

Meyer³

et al. 2018

PAR

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“…Flaps can be undertaken with low rate of complications even in patients with the comorbidities often seen in NSTIs. 9 However, flaps do create a second wound, and donor site complications are common when flaps are used in NSTIs. 9 In our practice, flaps are rarely created strictly for achieving complete wound coverage, with only one such flap noted in this study.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Wound Coverage Techniques in Extremity Necrotizing Soft Tissue Infections

Lauerman

Scalea

Eglseder

et al. 2018

The American Surgeon

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Little data exist about management of wounds created by debridement in necrotizing soft tissue infections (NSTIs). Multiple wound coverage techniques exist, including complete primary wound closure, split-thickness skin grafting, secondary intention, and flap creation. We hypothesized that all wound coverage techniques would be associated with high rates of successful wound coverage and low crossover rates to other wound coverage techniques. NSTIs over a three-year period were retrospectively reviewed. Both the initial and secondary wound coverage techniques (if necessary) were recorded. The primary outcome was the ability to achieve complete wound coverage. Overall, 46 patients with NSTIs had long-term data available. Of the patients undergoing split-thickness skin grafting as the initial wound coverage technique, 8/8 (100%) achieved complete wound coverage; and of those undergoing flap creation, 1/1 (100%) achieved complete wound coverage; and of those undergoing complete primary wound closure, 4/4 (100%) achieved complete wound coverage. Of the patients undergoing secondary intention as the initial wound coverage technique, 5/33 (15.2%) achieved complete wound coverage and 28/33 (84.8%) required a secondary wound coverage technique with split-thickness skin grafting. All 46 patients achieved long-term successful wound coverage. Time to wound coverage did not vary with initial wound coverage technique ( P = 0.44). Split-thickness skin grafting, flap creation, complete primary wound closure, and secondary intention are all reasonable choices for initial wound coverage for NSTIs. Although secondary intention had a low success rate as an initial wound coverage technique, all patients ultimately achieved complete wound coverage without a significant increase in time to coverage.

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“… 17 , 41 Plastic reconstructions depend on the size and topographic location of NF and may include free skin grafts with vacuum-assisted closure dressing. 42 We performed a special intervention involving the use of a pedicled trapezius musculocutaneous flap and free skin graft ( Figure 3(c), (d) ). NF of the head and neck remains a disease with a guarded prognosis.…”

Section: Discussionmentioning

confidence: 99%

Post-traumatic occipital psoriatic plaque complicated by extensive necrotizing fasciitis of the head and neck: a case report and literature review

et al. 2018

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Necrotizing fasciitis (NF) is a severe infection involving the superficial fascial layers, subcutaneous cellular tissue, and possibly skin. It usually has a fulminant evolution, rapidly leading to death in the absence of early diagnosis and aggressive surgical treatment. We herein report a rare case of NF secondary to a traumatized occipital psoriatic plaque in an alcoholic 47-year-old woman and compare this case with the published literature. The NF extended to the entire scalp, right face, and posterior and lateral cervical region. Despite the initially guarded prognosis, the patient’s survival emphasizes the importance of aggressive surgical treatment with wide excision of all necrotic structures without any aesthetic compromise.

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Free tissue transfer for necrotizing fasciitis reconstruction: A case series

Cited by 16 publications

References 28 publications

Defect reconstruction of the trochanter major after necrotizing fasciitis and multiple operations using an arteriovenous loop and latissimus dorsi free flap

Defect reconstruction of the trochanter major after necrotizing fasciitis and multiple operations using an arteriovenous loop and latissimus dorsi free flap

Efficacy of Wound Coverage Techniques in Extremity Necrotizing Soft Tissue Infections

Post-traumatic occipital psoriatic plaque complicated by extensive necrotizing fasciitis of the head and neck: a case report and literature review

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