Synthetic electrospun fiber matrix utilized in conjunction with homograft wound dressings in the management of massive necrotizing fasciitis excision: a case report

Abstract Introduction Necrotizing fasciitis (NF) is an aggressive bacterial infection of the skin and subcutaneous tissues that requires urgent surgical intervention to excise necrotic and infected tissues. Patients are often left with large, open wounds, for which there is no standard of care treatment protocol. A fully synthetic electrospun fiber matrix (SEFM) may regeneration of viable tissue while remaining resistant to harsh cleaning solutions needed to ensure a clean wound bed. Case description A 39-year-old male presented with NF requiring surgical excision of affected tissues across the torso, flanks, groin, anterior thighs, genitalia, and right arm, resulting in a total body surface area of 32% with exposed structures. Meshed SEFM sheets were applied with abdominal pads during the initial operation. To maintain SEFM contact with the wound and limit fluid loss, SEFM reapplication with homograft overlay was performed in sections starting at Day 35. Vascularized tissue was observed at Day 21 and covered the left torso and bilateral thighs by Day 35. Split-thickness skin grafts were then applied in sections with meshed homograft overlay for all excised regions, resulting in 95% graft take. Discussion The success demonstrated here suggests use of SEFM for post-excision NF wounds warrants further investigation. Learning points