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Surgical management of axillary necrotizing fasciitis: A case report
Author(s) -
YAMASAKI Osamu,
NAGAO Yoh,
SUGIYAMA Narushi,
OTSUKA Masaki,
IWATSUKI Keiji
Publication year - 2012
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/j.1346-8138.2011.01456.x
Subject(s) - medicine , axilla , surgery , debridement (dental) , fasciitis , bulla (seal) , fascia , surgical debridement , breast cancer , cancer , lung
Axillary necrotizing fasciitis (NF) is quite rare and requires special management with respect to debridement and delayed surgical reconstruction. A 76‐year‐old man presented to our emergency department with a 2‐day history of high fever, severe left axillary pain and redness. A few hours later, he developed discoloration and hemorrhagic bulla in the axilla, and the redness enlarged on the trunk. Emergency surgical debridement was performed. The blackish necrosis in the axilla was completely excised and the erythematous areas in the chest wall were cut down to the level of the fascia. Split‐thickness skin grafts were applied during the second debridement on the 30th day of hospitalization and negative pressure wound therapy was used. Although the grafts took partially, full thickness axillary defects remained. We performed reconstruction with a pedicled latissimus dorsi flap on day 78. This case highlights some of the important surgical considerations in the management of axillary NF.