J Korean Surg Soc.  2010 Jul;79(1):71-74. 10.4174/jkss.2010.79.1.71.

Necrotizing Fasciitis Following a Small Burn

• Cho YS
• Yang HT
• Yim H
• Park JM
• Kim D
• Hur J
• Kim JH
• Chun W

• KMID: 1455490
• DOI: http://doi.org/10.4174/jkss.2010.79.1.71

Abstract

Necrotizing fasciitis (NF) is a life-threatening soft tissue infection that manifests with a rapid course of inflammation and necrosis of the skin, subcutaneous fat, and fascia. NF commonly follows trauma to the skin, such as a laceration, scratch or insect bite. NF is a surgical emergency and requires both a high index of suspicion for diagnosis and prompt operative intervention. Early aggressive surgical intervention is important for improving survival rates. Mortality and morbidity can be decreased with early diagnosis, adequate and urgent surgical debridement, intensive supportive care, and wound resurfacing. Recently, we experienced a case of NF secondary to a third-degree contact burn on the dorsum of the right foot (1% body area). We report our therapeutic experience in this case, with a review of the literature.

Keyword

Necrotizing fasciitis; Burn

MeSH Terms

Burns
Debridement
Early Diagnosis
Emergencies
Fascia
Fasciitis, Necrotizing
Foot
Inflammation
Insect Bites and Stings
Lacerations
Necrosis
Skin
Soft Tissue Infections
Subcutaneous Fat
Survival Rate

Figure

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  Fig. 1 The right leg at initial presentation. The skin was erythematous with tense edema and had evidence of both hemorrhagic and non-hemorrhagic bullae.

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  Fig. 2 Intraoperative findings. Foul-smelling, turbid "dishwater" pus is seen in necrotizing fasciitis.

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  Fig. 3 The right leg and thigh after re-debridement. The whole fascia and some muscle were removed.

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  Fig. 4 The wound after first split thickness skin graft.

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  Fig. 5 Appearance of wound 3 months postoperatively.

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