1
|
Delavari S, Megas IF, Billner M, Reichert B, Breidung D. Necrotizing Fasciitis of the Hand: Management with Literature Review. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5981. [PMID: 39036596 PMCID: PMC11259388 DOI: 10.1097/gox.0000000000005981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 05/31/2024] [Indexed: 07/23/2024]
Abstract
This report presents a case of necrotizing fasciitis following a seemingly minor injury sustained from handling a spiny plant. Despite initial primary care by a physician, the patient presented with severe septic shock and necrotizing fasciitis of the hand, necessitating emergency surgical intervention. The use of scoring systems aided in the prompt recognition of the condition. Subsequent surgery was required due to infection progression, leading to significant soft tissue defects and functional impairment. The patient underwent multiple reconstructive procedures, including placement of dermis-replacement material and, ultimately, free flap reconstruction, to restore the hand function. This case report highlights the importance of rapid identification of potential cases of necrotizing fasciitis in cases of hand infections, demonstrates that scoring systems can assist in smaller affected body sites such as the hand, and illustrates the difficulties of defect reconstruction following necrotizing fasciitis.
Collapse
Affiliation(s)
- Sarina Delavari
- From the Department of Plastic, Reconstructive and Hand Surgery, Center for Severe Burn Injuries, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
- Department of General and Visceral Surgery, Hospital Martha-Maria, Nuremberg, Germany
| | - Ioannis-Fivos Megas
- From the Department of Plastic, Reconstructive and Hand Surgery, Center for Severe Burn Injuries, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
- Department of Orthopaedic and Trauma Surgery, Center of Plastic Surgery, Hand Surgery and Microsurgery, Evangelisches Waldkrankenhaus Spandau, Berlin, Germany
| | - Moritz Billner
- From the Department of Plastic, Reconstructive and Hand Surgery, Center for Severe Burn Injuries, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Bert Reichert
- From the Department of Plastic, Reconstructive and Hand Surgery, Center for Severe Burn Injuries, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - David Breidung
- From the Department of Plastic, Reconstructive and Hand Surgery, Center for Severe Burn Injuries, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
- Department of Health Management, Friedrich Alexander University Erlangen-Nuernberg (FAU), Erlangen, Germany
| |
Collapse
|