ABSTRACT
Necrotizing soft tissue infection (NSTI) is an uncommon but fatal and rapidly progressing disease which requires emergent recognition and prompt treatment. Patients of NSTI frequently suffer from large soft tissue defects, which require coverage of these defects by auto-skin graft or flap cover. It becomes a challenge to cover the soft tissue defects in an already sick patient. The patient of NSTI has a restricted skin graft donor site and a poor skin grafting bed. Here authors report a case of 50 years old female, known case of type 2 diabetes mellitus, who suffered from NSTI post intramuscular injection of the left gluteal region. Her left thigh, left gluteal region, lower back, pubic and perineal region were involved. She underwent multiple radical debridement’s followed by the use of Cadaveric human skin allografts to cover the raw area temporarily. Meanwhile, authors optimized the patient nutrition state and controlled the infections. Finally, raw areas were covered with an autologous skin graft, and the patient discharged in stable condition.
ABSTRACT
Fournier’s gangrene is a rare, idiopathic, life-threatening, necrotizing fasciitis of the genitals and perineum caused by both aerobic and anaerobic bacterial flora. The synergistic effect of the bacteriae results in fulminating gangrene, multiple organ failure, and can even lead to death. Most commonly it has a predilection for diabetic and alcohol abused individuals, those who have impaired immunity. Genital trauma is frequently recognized vector for infection initiation. Timely recognition of the disease process and initiation of treatment with aggressive debridement and antibiotic administration is called for. The advanced age of the patient, extensive disease, delayed presentation with shock or sepsis and organ failures, all contribute to mortality in Fournier’s gangrene. In this case report, we recall an account of our tryst with Fournier’s gangrene management.