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Necrotizing Fasciitis of Chest and Neck

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Patient History

Patient presented with necrotizing fasciitis* after injecting a mixture of meth and industrial cleaner into her neck, missing the vein. Patient developed a rapid, chemical-induced soft tissue necrosis.

Treatment

Patient went to the operating room four times for serial surgical debridement. The patient could not return to the OR, so Restrata® Sheets were placed bedside in the ICU. Various sizes of Restrata Sheets were placed over the wound. Restrata MiniMatrix™ was used in the space between the patient’s breast and chest wall due to the irregular topography. A non-adherent was placed on the wound followed by negative pressure wound therapy (NPWT). NPWT was changed bedside once a week and the patient never returned to the OR for a split-thickness skin graft (STSG).

Conclusion

Two months after the initial application of Restrata, the wound showed a healthy granulation bed and wound healing was positive. The wound was taken to eventual closure via secondary intent. Three months after the initial application, the patient was discharged.

Week 0

Presentation, irrigation, and debridement; Restrata® Sheet application.

Week 1

Restrata beginning to incorporate

Week 2

Restrata mostly integrated, granulation tissue beginning to develop

Week 4

Restrata completely resorbed, healthy granulation tissue

Week 8

Continued healing progression

*Infection was controlled and no longer present at the time of the inital Restrata application.

**Disclaimer: Restrata has not been studied in wounds that extend into the tendon, muscle, joint capsule, or bone. Restrata should not be applied until excessive exudate, bleeding, acute swelling, and infection is controlled. Please refer to the Instructions for Use for a full list of indications, contraindications, precautions, and warnings.

MKG-30152

Related Clinical Case Studies

Management of Massive Necrotizing Fasciitis Excision

Aggressive case of necrotizing fasciitis in the torso and extremities. The total excised area was 4,832 cm² with exposed fascia, muscle, and several ribs. Over the course of 123 days and multiple applications of Restrata, only minor openings remained.

Traumatic Gunshot Wound

After 3 applications, Restrata helped to provide a better-granulated tissue base for a STSG in this complex wound.

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