Surgical management of axillary necrotizing fasciitis: A case report

Osamu Yamasaki, Yoh Nagao, Narushi Sugiyama, Masaki Otsuka, Keiji Iwatsuki

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)309-311
Number of pages3
JournalJournal of Dermatology
Volume39
Issue number3
DOIs
Publication statusPublished - Mar 1 2012

Keywords

  • Streptococcus pyogenes
  • axilla
  • debridement
  • latissimus dorsi flap
  • toxic shock-like syndrome

ASJC Scopus subject areas

  • Dermatology

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