Spontaneous clostridial myonecrosis after pregnancy - emergency treatment to the limb salvage and functional recovery: a case report

Abstract

Clostridial myonecrosis (CM) is a rare, life threatening necrotizing infection of a skeletal muscle caused by Clostridium perfringens in the majority of cases. The diagnosis may be difficult because of few diagnostic and cutaneous signs early in its course. Standard therapy involves surgical debridements of a devitalized tissue and high-dose organism-specific antibiotic therapy. The hyperbaric oxygen has also showed its usefulness in the treatment of these infections. Autograft systems as tissue replacement, based on bioengineered materials, have been demonstrated to be safe and effective treatments for chronic wounds and a suitable physiotherapy is recommended for the recovery of functional impairments of upper extremities. We present a rare case of CM of right upper limb treated with a combination of standard treatments and new techniques.

Keywords: Clostridium perfringens; Myonecrosis; Rehabilitation; Tissue regeneration.

Figure 1

(A) Aspect of right hand with Penrose drain: subcutaneous tissue appears oedematous with the presence of bullae and signs of necrosis. (B) Aspect at the second surgical operation. Necrosis was limited and oedema was lacking. No signs of systemic toxicity. (C) CT findings: carpal view. It shows the oedema of subcutaneous tissue and the presence of the bullae.

Figure 2

(A, B) One month post‐operative view .The skin growth on the wound with good satisfaction from aestethic point of view, but there is an incomplete closure of the hand. (C, D) Six years post‐operative view. Complete functional recovery and aesthetic.