Conflict interest: none.
Surgical management of axillary necrotizing fasciitis: A case report
Article first published online: 29 DEC 2011
© 2011 Japanese Dermatological Association
The Journal of Dermatology
Special Issue: Special Issue: Psoriasis (pages 211-289)
Volume 39, Issue 3, pages 309–311, March 2012
How to Cite
YAMASAKI, O., NAGAO, Y., SUGIYAMA, N., OTSUKA, M. and IWATSUKI, K. (2012), Surgical management of axillary necrotizing fasciitis: A case report. The Journal of Dermatology, 39: 309–311. doi: 10.1111/j.1346-8138.2011.01456.x
- Issue published online: 21 FEB 2012
- Article first published online: 29 DEC 2011
- Received 16 September 2011; accepted 30 October 2011.
- latissimus dorsi flap;
- Streptococcus pyogenes;
- toxic shock-like syndrome
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.