Intercostobrachial nerve injury from axillary dissection resulting in necrotizing fasciitis after a burn injury.
We present here the successful management of a 50-year-old female patient who developed necrotizing fasciitis after a burn injury to her left arm. The burn injury was sustained in a minimally lymphoedematous arm, in an area of post surgical paresthesia caused by division of the intercostobrachial nerve. This is a common consequence of axillary lymph node dissection. We discuss the diagnosis, management strategies, and the available literature. We conclude that division of the intercostobrachial nerve increases the risk of morbidity significantly and support the view that its preservation at the time of axillary surgery is preferable.
Brooks
Peter
P
The Yorkshire Regional Burns Unit, Department of Plastic Surgery, Pinderfields Hospital, Wakefield, UK.
Malic
Claudia
C
Austen
Orla
O
D001365:Axilla / Q000294:innervation*; D001943:Breast Neoplasms / Q000601:surgery; D002056:Burns / Q000150:complications*; D002278:Carcinoma in Situ / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000601:surgery; D019115:Fasciitis, Necrotizing / Q000209:etiology*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008209:Lymphedema / Q000209:etiology*; D008875:Middle Aged; D010292:Paresthesia / Q000209:etiology; D011183:Postoperative Complications