Serial irrigation and debridement with the use of Kerecis in the treatment of necrotizing fasciitis: A case report

Q4 Medicine

Trauma Case Reports Pub Date : 2025-05-27 DOI:10.1016/j.tcr.2025.101196

Collin T. Erickson, Robert D. Garner, Katherine A. Manseau, Jacob A. Frisbie, Charles Orth

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引用次数: 0

Abstract

Introduction

Necrotizing fasciitis is a life-threatening infection that requires emergent irrigation and radical debridement. One of the challenges surgeons often encounter is gaining adequate soft tissue coverage of the defects that remain after debridement. Kerecis SurgiClose (Coloplast, Denmark), a fish skin xenograft, is one option for wound coverage. This has demonstrated potential for fostering an environment beneficial for wound healing in various types of wounds.

Case presentation

A 39-year-old female presented to the emergency department with a one-week history of left knee pain after a fall. She had a wound on the anterior knee, which began to develop erythema. Necrotizing fasciitis was diagnosed with the patient's Laboratory Risk Indication of Necrotizing Fasciitis (LRINEC) score of 10. She was started on antibiotics and was taken to surgery. She underwent debridements until a bed of healthy tissue was appreciated. Kerecis SurgiClose was applied over the defect which helped create a healthy tissue bed prior to placing a skin autograft. After grafting, daily dressing changes started and evident healing in the recipient site was seen.

Conclusion

This case demonstrates the importance of early diagnosis of necrotizing fasciitis, as well as the utility of fish xenografts in wound coverage once a healthy tissue environment is established. These xenografts are used for many types of wounds, however there is a paucity in the literature supporting their use in necrotizing soft tissue infections. The properties of these grafts potentiate various aspects of healing and show promising results in the healing of deep soft tissue voids.

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应用Kerecis连续冲洗清创治疗坏死性筋膜炎1例

坏死性筋膜炎是一种危及生命的感染，需要紧急冲洗和彻底清创。外科医生经常遇到的挑战之一是在清创后获得足够的软组织覆盖缺损。Kerecis SurgiClose（康乐保，丹麦）是一种鱼皮异种移植，是修复伤口的一种选择。这已经证明了在各种类型的伤口中培养有利于伤口愈合的环境的潜力。病例介绍一名39岁女性，因跌倒后左膝疼痛一周就诊于急诊科。她膝盖前侧有个伤口，开始出现红斑。坏死性筋膜炎诊断时，患者的实验室危险指征（LRINEC）评分为10分。她开始服用抗生素，并被送往手术。她接受了清创手术，直到发现一床健康组织。Kerecis SurgiClose应用于缺损处，有助于在放置自体皮肤移植物之前创造一个健康的组织床。移植后，开始每日换药，可见受体部位明显愈合。结论本病例表明早期诊断坏死性筋膜炎的重要性，以及一旦建立健康的组织环境，异种鱼移植在伤口覆盖中的应用。这些异种移植物用于许多类型的伤口，但是文献中支持其用于坏死性软组织感染的文献很少。这些移植物的特性增强了愈合的各个方面，并在深层软组织空洞的愈合中显示出有希望的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Trauma Case Reports Medicine-Emergency Medicine

CiteScore

0.60

自引率

0.00%

发文量

131

审稿时长

26 weeks

期刊介绍： Trauma Case Reports is the only open access, online journal dedicated to the publication of case reports in all aspects of trauma care and accident surgery. Case reports on all aspects of trauma management, surgical procedures for all tissues, resuscitation, anaesthesia and trauma and tissue healing will be considered for publication by the international editorial team and will be subject to peer review. Bringing together these cases from an international authorship will shed light on surgical problems and help in their effective resolution.