Plastic and Reconstructive Surgery, Global Open (Dec 2018)

Negative-pressure Wound Therapy for Periocular Necrotizing Fasciitis

  • John W. Gillespie, III, MD,
  • Jui K. Pandya, MD,
  • Shilpa M. Agarwal, MD,
  • Andrew A. Gassman, MD,
  • Mark Krakauer, MD, MPhil

DOI
https://doi.org/10.1097/GOX.0000000000001921
Journal volume & issue
Vol. 6, no. 12
p. e1921

Abstract

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Summary:. Periocular necrotizing fasciitis is a rare, but potentially blinding, or even fatal disease. The authors report a case of a 44-year-old man who presented with quiescent bilateral periocular and facial necrotizing fasciitis. The patient was treated with antibiotics and surgical debridement, followed by negative-pressure wound therapy (NPWT), until the wound bed was thought to be healthy enough to support bilateral upper eyelid full-thickness skin grafts. NPWT appeared to decrease local edema; speed reperfusion and granulation tissue formation; and served to stabilize the skin grafts against the wound bed, while not causing any ocular complications. NPWT can be a safe and effective adjunct treatment for periocular necrotizing fasciitis.