Surgical management of axillary necrotizing fasciitis: A case report

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

Research output: Contribution to journalArticle

3 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 2012

Fingerprint

Necrotizing Fasciitis
Debridement
Axilla
Negative-Pressure Wound Therapy
Transplants
Superficial Back Muscles
Fascia
Thoracic Wall
Blister
Hospital Emergency Service
Hospitalization
Emergencies
Fever
Necrosis
Pain
Skin

Keywords

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

ASJC Scopus subject areas

  • Dermatology

Cite this

Surgical management of axillary necrotizing fasciitis : A case report. / Yamasaki, Osamu; Nagao, Yoh; Sugiyama, Narushi; Otsuka, Masaki; Iwatsuki, Keiji.

In: Journal of Dermatology, Vol. 39, No. 3, 03.2012, p. 309-311.

Research output: Contribution to journalArticle

Yamasaki, Osamu ; Nagao, Yoh ; Sugiyama, Narushi ; Otsuka, Masaki ; Iwatsuki, Keiji. / Surgical management of axillary necrotizing fasciitis : A case report. In: Journal of Dermatology. 2012 ; Vol. 39, No. 3. pp. 309-311.
@article{bbab8379c0744c8a86961676d2cfd61f,
title = "Surgical management of axillary necrotizing fasciitis: A case report",
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.",
keywords = "axilla, debridement, latissimus dorsi flap, Streptococcus pyogenes, toxic shock-like syndrome",
author = "Osamu Yamasaki and Yoh Nagao and Narushi Sugiyama and Masaki Otsuka and Keiji Iwatsuki",
year = "2012",
month = "3",
doi = "10.1111/j.1346-8138.2011.01456.x",
language = "English",
volume = "39",
pages = "309--311",
journal = "Journal of Dermatology",
issn = "0385-2407",
publisher = "Wiley-Blackwell",
number = "3",

}

TY - JOUR

T1 - Surgical management of axillary necrotizing fasciitis

T2 - A case report

AU - Yamasaki, Osamu

AU - Nagao, Yoh

AU - Sugiyama, Narushi

AU - Otsuka, Masaki

AU - Iwatsuki, Keiji

PY - 2012/3

Y1 - 2012/3

N2 - 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.

AB - 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.

KW - axilla

KW - debridement

KW - latissimus dorsi flap

KW - Streptococcus pyogenes

KW - toxic shock-like syndrome

UR - http://www.scopus.com/inward/record.url?scp=84857641797&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84857641797&partnerID=8YFLogxK

U2 - 10.1111/j.1346-8138.2011.01456.x

DO - 10.1111/j.1346-8138.2011.01456.x

M3 - Article

C2 - 22211460

AN - SCOPUS:84857641797

VL - 39

SP - 309

EP - 311

JO - Journal of Dermatology

JF - Journal of Dermatology

SN - 0385-2407

IS - 3

ER -