A successful process of treatment with necrotizing fasciitis of upper extremities in patients with diabetes mellitus: a case report

Abstract

Necrotizing fasciitis (NF) represents a rapidly progressive, life-threatening infection involving the fascia and subcutaneous tissue. Early diagnosis and intervention are crucial to treat, especially in diabetic patients.

Case presentation: This case report presents on a patient with diabetes mellitus rapidly developed a NF of the upper extremities following a minor trauma in the palmar of greater thenar. In the initial stages of her hospital admission, severe hand soft tissue infection, and systemic toxicity is the most prominent clinical manifestation. During her hospitalization, efficacious multidisciplinary treatment was carried out to avoid severe consequences.

Clinical discussion and conclusion: The objective of this case report is to present a successful individual strategy in a complex case to standardize the treatment process. Accurate and standardized management can improve the prognosis of patients affected from upper extremities NF of diabetic avoiding and severe complications and saving lives.

Keywords: case report; diabetes mellitus; necrotizing fasciitis.

Figure 1

Clinical photographs of wound healing process of necrotizing fasciitis of upper extremities in diabetic patients. Initially presentation when the patient just entered our institution, were shown as (A, B); C showed the wound 8 days after emergency debridement; The wounds after the second debridement and the second round of VSD were as shown in D; E and F represented autologous intermediate-thickness skin grafting from the patient’s ipsilateral thigh and 2 weeks after operation, respectively. The follow-up assessment at 3 (G), 6 (H) months from the first surgery.

Figure 2

Management algorithm.