Summary
This case report describes the clinical management of necrotizing soft tissue infection (NSTI) of the bilateral forearms in a patient with a history of intravenous heroin use. Following surgical debridement, a multi-component dressing regimen (hypochlorous acid cleansing, carboxymethylcellulose fibre with 1.2% ionic silver, and hydrocellular foam) was applied to promote moist wound healing. The dressing protocol appeared to accelerate granulation tissue formation and pain control, enabling skin grafting at 10 days post-debridement with complete graft uptake, though follow-up was limited by early discharge against medical advice.
UK applicability
The findings relate to specialist wound management practices applicable across UK healthcare settings, though this is a single case report with limited generalisability. The approach may be relevant to UK wound care pathways for NSTI management in vulnerable populations including those with substance use disorders.
Key measures
Days to granulation tissue formation; days to skin graft; graft uptake percentage; pain tolerance during dressing changes; wound healing progression
Outcomes reported
The study reported time to healthy granulation tissue formation (6 days post-debridement), time to skin grafting (10 days post-debridement), skin graft uptake rate (100% on day 8 post-graft), and pain tolerance during dressing changes. Clinical outcomes were measured in a single patient with bilateral upper extremity necrotizing soft tissue infection.
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