title: Successful salvage and reconstruction of a finger threatened by Vibrio vulnificus necrotising fasciitis using fenestrated-type artificial dermis and three steps of topical negative pressure wound therapy.
abstract: Vibrio vulnificus can cause severe skin and soft tissue infection (SSTI). The pathogen is an opportunistic marine bacterium that is likely to infect patients with chronic liver disease, patients in an immunocompromised state, and those in end-stage renal disease. V. vulnificus gains entry through soft tissues by direct penetration of a wound by infected marine organisms, such as raw oysters, shellfish and other seafood, or by exposing a wound to contaminated water. Despite its ease of entry, V. vulnificus necrotising fasciitis with compartment syndrome has rarely been described. We report a case of an elderly patient with end-stage renal disease undergoing haemodialysis, who developed necrotising fasciitis following infection by V. vulnificus through a puncture injury while cleaning fish. A successful salvage and reconstruction surgery was performed using fenestrated-type artificial dermis followed by negative pressure wound therapy. This case presents a reasonable treatment option for threatening V. vulnificus necrotising fasciitis with compartment syndrome.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.|Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.
authors.forename: Chi-Yu
authors.initials: CY
authors.lastname: Wang
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Hao-Yu
authors.initials: HY
authors.lastname: Chiao
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Chang-Yi
authors.initials: CY
authors.lastname: Chou
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Chien-Ju
authors.initials: CJ
authors.lastname: Wu
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Chun-Kai
authors.initials: CK
authors.lastname: Chang
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Tzi-Shiang
authors.initials: TS
authors.lastname: Chu
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Niann-Tzyy
authors.initials: NT
authors.lastname: Dai
mesh_terms: D000369:Aged, 80 and over; D019115:Fasciitis, Necrotizing / Q000209:etiology* / Q000601:surgery*; D005260:Female; D005385:Fingers / Q000382:microbiology / Q000601:surgery*; D006801:Humans; D007676:Kidney Failure, Chronic; D054843:Negative-Pressure Wound Therapy; D017768:Skin, Artificial; D016896:Treatment Outcome; D041261:Vibrio vulnificus / Q000472:pathogenicity*; D014946:Wound Infection / Q000601:surgery*
keywords: Artificial dermis; Compartment syndrome; NPWT; Necrotising fasciitis; Vibrio vulnificus