Necrotizing Soft Tissue Infection Management: a Clinical Case Study

Abstract

Necrotizing soft tissue infection is a rare (0.4 cases per 100,000 population) but very severe pathology with a mortality rate up to 10%. The paper presents a clinical case of successful management of necrotizing soft tissue infection of the right arm, lateral wall of the chest and abdomen. The dynamics of the wound process was controlled by clinical, bacteriological, X-ray and ultrasound examinations. The cause of necrotizing soft tissue infection in this patient was the associated anaerobic nonclostridial and aerobic flora. Numerous surgical interventions were used to manage the patient; they were aimed at the excision of the necrotic tissue at the start of treatment, plastic surgery of postoperative wounds with local tissues was used at the end of treatment. The progression of the necrotic process was stopped after the third intervention. In addition to surgical treatment, the patient received antibacterial, detoxification, and immunostimulating therapy. Despite numerous staged surgeries with the excision of the necrotic skin, subcutaneous fat and fascia, it was possible to completely restore the patient’s ability to work.