PMC3996171_01
Open fasciotomy wound closure with extended NPWT-assisted dermatotraction in necrotizing fasciitis; A 59-year-old male patient with necrotizing fasciitis on his right thigh showed contracted skin margins with necrotic tissues on the 14th day after initial fasciotomy. (A). After 46 days of wound preparation, the elastic vessel loop is applied for the dermatotraction in a shoelace manner (B). The extended NPWT assisted the underlying dermatotraction in closing the open fasciotomy wound (C). After the 14 days of treatment, the fasciotomy wound could be closed directly (D).
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F1
The exposed wound showed contracted skin margins with partially necrotic subcutaneous tissues and fascia (Figure 1A). After 46 days of wound preparation following initial fasciotomy, the patient underwent NPWT-assisted dermatotraction (Figure 1B, C). After 14 days of treatment, the fasciotomy wound could be closed directly (Figure 1D).
PMC3996171_02
Open fasciotomy wound closure with extended NPWT-assisted dermatotraction in necrotizing fasciitis; A 62-year-old male patient with necrotizing fasciitis on the left lower extremity underwent open fasciotomy on his thigh and lower leg. (A). After 7 days of thorough wound debridement and preparation, extended NPWT-assisted dermatotraction was applied (B). After two cycles of treatment, the fasciotomy wounds were closed directly, and the posterior calf's raw surface was covered with split-thickness skin graft (C). Three months after wound closure, the wounds were completely healed without complications (D).
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F2
The patient underwent emergent open fasciotomy of lower extremity with debridement (Figure 2A). After seven days of thorough wound debridement and irrigation, the patient underwent two cycles of extended NPWT-assisted dermatotraction for the open fasciotomy wound closure (Figure 2B). Except for the necrosed posterior calf skin, which was covered with split-thickness skin grafts, the open fasciotomy wounds were closed directly without tension (Figure 2C). The patient was followed up at the outpatient department for 59 months, and there were no complications except for widening of the scar (Figure 2D).
PMC3996171_03
Open fasciotomy wound closure with extended NPWT-assisted dermatotraction in necrotizing fasciitis; A 43-year-old male patient with necrotizing fasciitis that had developed an abscess in the left axilla underwent open fasciotomy one month before presentation. (A). After 40 days of wound preparation since initial fasciotomy, the patient underwent NPWT-assisted dermatotraction, which decreased the size of wound prominently after 6 days of treatment (B). The wound was closed directly after 40 days of NPWT assisted dermatotraction (C). The patient was followed up for 27 months and the wound was completely healed without complications (D).
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F3
He was treated with serial surgical debridement at a local clinic for one month, but still had an open wound of 50 x 20 cm on his left trunk when he transferred to our department (Figure 3A). The wound had decreased prominently six days after initial application of the NPWT-assissted dermatotraction (Figure 3B). We were able to close the wound primarily without tension on 40 days of the treatment without infection (Figure 3C). The patient was followed up regularly at the outpatient department, and there was no complication but a widened scar at 27 months (Figure 3D).