A case of perineal necrotizing fasciitis treated with microskin implantation

Abstract

A case of refractory perineal necrotizing fasciitis treated by microskin implantation is reported. A 56-year-old male presented with perineal ulcer, crusting and pain for 15 months. Dermatologic examination: large ulcers on the perineum, about 25 cm×28 cm in size, deep to the muscle layer, with a thick black crust separated from the surrounding tissue on the surface, yellow-white secretions, and purple-red surrounding skin. Histopathology revealed partial defect, hemorrhage and necrosis, fibrinoid degeneration of small blood vessel wall in the superficial dermis in the defect area, inflammatory cell infiltration, and increased fibrous tissue. According to clinical manifestations and histopathological results, the patient was diagnosed with perineal necrotizing fasciitis. After multiple perineal ulcer debridement and continuous negative pressure suction (VSD), microskin implantation were performed. Skin island gradually formed and merged to form the skin surface, and finally covered the wound surface. After a 2-year follow-up, the patient's wounds recovered well and some scars healed.

Keywords

• perineal necrotizing fasciitis
• microskin implantation