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. 2022 Sep 23;49(5):608-610.
doi: 10.1055/s-0042-1756288. eCollection 2022 Sep.

A Peculiar Case of Ischemic Fasciitis Appeared on a Pressure Ulcer after 10 Days of Negative Pressure Wound Therapy

Vania Recchi  1 , Benedetta Peltristo  1 , Davide Talevi  1 , Alessandro Scalise  1 , Giovanni Di Benedetto  1
Affiliations

A Peculiar Case of Ischemic Fasciitis Appeared on a Pressure Ulcer after 10 Days of Negative Pressure Wound Therapy

Vania Recchi et al. Arch Plast Surg. .

Abstract

In this article, we reported a single case of ischemic fasciitis in a young woman with a progressive immobilization due to a multifocal demyelinating disease of central nervous system, which appeared on an extensive pressure ulcer of the sacral region treated with 10 days of negative-pressure wound therapy (NPWT). Wound examination revealed a significant nontender brown neoformation (9 cm in length × 10 cm in width × 7 cm in height), fixed to the sacrum, presenting hard consistency, and grown in the central portion of the sacral pressure sore. The histologic examination showed central fibrinoid necrosis, and vascular and atypical fibroblastic proliferations, and a diagnosis of ischemic fasciitis was made. Ischemic fasciitis is a rare benign proliferation of atypical fibroblasts that occurs in physically weak patients with reduced mobility. In the literature, the relationship between the use of NPWT on pressure ulcers and the development of ischemic fasciitis is, to the best of our knowledge, not described yet.

Keywords: ischemic fasciitis; negative-pressure wound therapy; plastic surgery; pressure ulcer; pseudosarcomatous.

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Conflict of interest statement

Conflict of Interest The authors confirmed that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Picture taken the first time the patient presented to our department for a massive neoformation grown in the central portion of the sacral pressure sore after 10 days of NPWT. NPWT, negative-pressure wound therapy.
Fig. 2
Fig. 2
Central fibrinoid necrosis, surrounded by enlarged atypical proliferating fibroblasts, myofibroblasts, chronic inflammatory cells, and reactive vascularity (hematoxylin and eosin).
Fig. 3
Fig. 3
Preoperative picture taken few weeks later Fig. 1 . Particularly noteworthy is the fast-growing of the mass.
Fig. 4
Fig. 4
Postoperative picture taken 8 months after the surgery.
See this image and copyright information in PMC

References

    1. Montgomery E A, Meis J M, Mitchell M S, Enzinger F M. Atypical decubital fibroplasia. A distinctive fibroblastic pseudotumor occurring in debilitated patients. Am J Surg Pathol. 1992;16(07):708–715. - PubMed
    1. Ilaslan H, Joyce M, Bauer T, Sundaram M. Decubital ischemic fasciitis: clinical, pathologic, and MRI features of pseudosarcoma. AJR Am J Roentgenol. 2006;187(05):1338–1341. - PubMed
    1. Baldassano M F, Rosenberg A E, Flotte T J. Atypical decubital fibroplasia: a series of three cases. J Cutan Pathol. 1998;25(03):149–152. - PubMed
    1. Lehmer L M, Moore J B, Ragsdale B D. Ischemic fasciitis: enhanced diagnostic resolution through clinical, histopathologic and radiologic correlation in 17 cases. J Cutan Pathol. 2016;43(09):740–748. - PubMed
    1. Liegl B, Fletcher C D. Ischemic fasciitis: analysis of 44 cases indicating an inconsistent association with immobility or debilitation. Am J Surg Pathol. 2008;32(10):1546–1552. - PubMed