Use of Amniotic Membrane as Dressing in Cervical Necrotizing Fasciitis

Abstract

Cervical necrotizing fasciitis (CNF) is a rapidly spreading, soft tissue infection of polymicrobial origin characterized by necrosis of subcutaneous tissue and underlying fascia, with rapid spread of the infection and inflammation along fascial planes from the neck to the mediastinum. Initially, this infection spares the underlying muscle and overlying skin, but with progression, there is myonecrosis and mottling of the skin caused by thrombosis of feeding vessels as they pass through the infected fascial planes. CNF, if left unchecked, invariably leads to systemic toxicity, multisystem organ failure, and eventual death. In modern practice, CNF occurs sporadically, which makes a true estimate of its prevalence difficult to ascertain. Early diagnosis is the key to treat this infection. Surgery, antibiotics, and supportive measures remain the mainstay treatment modalities. Postsurgical wound management remains a challenge. This report presents a case of CNF with extensive postsurgical wound successfully managed using amniotic membrane (AM) as a dressing material without any additional reconstructive procedure.