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Case Study/Series
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Successful Treatment of Necrotizing Fasciitis (NF) Cases in Rural Eastern North Carolina First Author: Stephanie Slayton Authors: Monica Carion-Jones Introduction: NF is a rare disease that requires extensive surgical debridement, resulting in a large wound with functional and cosmetic deficits. Objective: Describe treatment of NF using innovative dressing applications instead of gold standard, hyperbaric oxygen therapy, not available at our institution. Method/Results: Patient A: 52yo BM. After serial surgical debridement, Physical Therapy (PT) treatment consisted of pulsatile lavage with suction (PLWS) and silver dressing (SD)* every 48 hours. Negative pressure wound therapy (NPWT)1 was applied for 48 hours prior to first of many split-thickness skin grafts (STSG). Ninety Percent of the wound was ultimately grafted, which had a 95% total take. Patient underwent inpatient rehabilitation for functional training. Patient B: 62yo WM. After initial surgical debridement, PT treatment consisted of PLWS, with SD* every 48 hours. At week two NPWT 1 was applied with SD* underneath. After six weeks, patient was discharged home with outpatient wound care. Patients wound has shown a 50% reduction in wound size after 8 weeks of treatment. Patient C: 45yo WM. After serial surgical debridement, PT treatment included PLWS and Dakin's solution moistened gauze daily. A NPWT trial was performed for 48 hours, which was discontinued due to further surgical debridement, which made the NPWT contraindicated. Patient treatment was then switched to SD* every 48 hours. The wound no longer has purulent drainage and is 90% granulating tissue. Patient is being followed in hospital setting. Conclusion: Successful functional and cosmetic outcomes can be achieved for patients with NF with innovative dressing applications. |
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