Management of Necrotizing Fasciitis of the Abdominal Wall after Hysterectomy: A Case Report

Abstract

Necrotizing fasciitis is a rare dermo-hypodermal condition involving necrosis of cutaneous, subcutaneous and fascial tissues. Its occurrence in postoperative settings is an exceptional and serious phenomenon, with a life-threatening prognosis: it is a medical-surgical emergency.The diagnosis is clinically suspected in the presence of hyperalgesic wall sepsis disproportionate to the extent of the lesions. Biological criteria are established by the LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score, which can help differentiate necrotizing fasciitis from severe cellulitis. Diagnosis is difficult at first, given the lack of specific signs, which worsens the prognosis, which depends on rapid medical and surgical management.Treatment is based on extensive and aggressive trimming of necrotic tissue with drainage, combined with active and intensive resuscitation, and broad-spectrum antibiotic therapy tailored to the results of bacteriological sampling. We report the case of a 42-year-old female patient presenting with necrotizing fasciitis of the anterolateral abdominal wall after hysterectomy.