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Case Reports
. 2025 May 27:58:101196.
doi: 10.1016/j.tcr.2025.101196. eCollection 2025 Aug.

Serial irrigation and debridement with the use of Kerecis in the treatment of necrotizing fasciitis: A case report

Collin T Erickson  1   2 , Robert D Garner  1   2 , Katherine A Manseau  1   2 , Jacob A Frisbie  1   2 , Charles Orth  1   2
Affiliations
Case Reports

Serial irrigation and debridement with the use of Kerecis in the treatment of necrotizing fasciitis: A case report

Collin T Erickson et al. Trauma Case Rep. .

Abstract

Introduction: Necrotizing fasciitis is a life-threatening infection that requires emergent irrigation and radical debridement. One of the challenges surgeons often encounter is gaining adequate soft tissue coverage of the defects that remain after debridement. Kerecis SurgiClose (Coloplast, Denmark), a fish skin xenograft, is one option for wound coverage. This has demonstrated potential for fostering an environment beneficial for wound healing in various types of wounds.

Case presentation: A 39-year-old female presented to the emergency department with a one-week history of left knee pain after a fall. She had a wound on the anterior knee, which began to develop erythema. Necrotizing fasciitis was diagnosed with the patient's Laboratory Risk Indication of Necrotizing Fasciitis (LRINEC) score of 10. She was started on antibiotics and was taken to surgery. She underwent debridements until a bed of healthy tissue was appreciated. Kerecis SurgiClose was applied over the defect which helped create a healthy tissue bed prior to placing a skin autograft. After grafting, daily dressing changes started and evident healing in the recipient site was seen.

Conclusion: This case demonstrates the importance of early diagnosis of necrotizing fasciitis, as well as the utility of fish xenografts in wound coverage once a healthy tissue environment is established. These xenografts are used for many types of wounds, however there is a paucity in the literature supporting their use in necrotizing soft tissue infections. The properties of these grafts potentiate various aspects of healing and show promising results in the healing of deep soft tissue voids.

Keywords: Fish xenograft; Irrigation and debridement; Limb salvage; Necrotizing infection; Wound healing.

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Conflict of interest statement

The contact author has declared that none of the authors listed have competing interests.

Figures

Fig. 1
Fig. 1
Patient's left knee at admission.
Fig. 2
Fig. 2
Left knee after three debridements, prior to Kerecis grafting.
Fig. 3
Fig. 3
Patient's knee after first Keracis application.
Fig. 4
Fig. 4
Left knee one week after first Kerecis graft with reapplication of Kerecis graft.
Fig. 5
Fig. 5
Left knee one week after second Kerecis graft.
Fig. 6
Fig. 6
Left knee after third Kerecis application.
Fig. 7
Fig. 7
Left knee prior to application of skin graft.
Fig. 8
Fig. 8
Graft at one week after removal of dressings.
Fig. 9
Fig. 9
Left knee recipient site upon discharge.
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