Abstract
Necrotising soft tissue infection (NSTI) is a rapidly progressing disease that presents a surgical emergency. Timely antibiotics, radical debridement of infected tissues and adjuvant hyperbaric oxygen therapy are the foundations of its treatment. Split-skin graft (SSG) is the main reconstruction technique due to its simplicity and dependability. Dermal substitutes, as well as creating a suitable wound bed for grafting, aim to recreate the inherent thickness and pliability of skin. One innovation, Novosorb™ (produced by PolyNovo Ltd, Port Melbourne, Australia), is a biodegradable temporising matrix (BTM) that is an entirely synthetic implantable dermal matrix that creates a neo-dermis in complex wounds.
Highlights
Necrotising soft tissue infection (NSTI) is a rapidly progressing disease that presents a surgical emergency
Where there is a contaminated wound with extensive soft tissue loss and exposed tendons, Split-skin graft (SSG) are at risk of failure
Necrotising soft tissue infection is a devastating disease that often leaves a patient with large fullthickness skin loss
Summary
Necrotising soft tissue infection (NSTI) is a rapidly progressing disease that presents a surgical emergency. At day 37 post-admission, the right leg and dorsum of the foot were surgically prepared and implanted with Novosorb BTM. The patient underwent regular dressing changes while the implanted BTM became integrated over the 21 days, which allowed for monitoring of formation haematoma and infection. Over this period, the BTM became gradually more hyperaemic and vascularised (Figure 2). Further serial debridement of the infected devitalised tissue led to the right leg anterior compartment tendons becoming exposed, desiccated and lacking paratenon— this portion of the wound was no longer graftable. He is currently walking independently without aids, working fulltime in sales and has returned to surfing
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