After necrotising fasciitis, a patient may need skin grafts to improve the aesthetic appearance of the scarring.
Tissue necrosis and necrotising fasciitis
Necrotising fasciitis causes the tissue to breakdown and die. This is called tissue necrosis. Because it is such an aggressive infection, it will not take long for the tissue to deteriorate. The tissue can turn from perfectly healthy to completely necrotic in a very short space of time – even as little as 24 hours.
The bacteria that cause the infection will multiply rapidly; this means the area of dead tissue will also spread rapidly. Within days a patient will have a large area of gangrenous tissue. This may be so deep that it extends down to the bone.
Why are skin grafts needed after necrotising fasciitis?
All of the infected tissue will have to be surgically removed. If a patient has widespread necrosis, this will leave a significant defect.
Medical treatment can ensure that the wound closes. This may take some time and will usually involve continual re-dressing of the wounds, hydration and VAC-assisted closure. It may also be necessary to use skin grafts to promote healing.
Skin grafts are when the top layer of skin (epidermis) and sometimes also the second layer of skin (dermis) are taken from another part of the body – usually the buttocks or thigh. The area it is taken from is known as the donor site. The skin is then placed over the lost or damaged tissue and held in place with stitches and glue.
After about one week, the skin graft will connect with the blood supply and will integrate into the new site. This will help to close the gaping wound that has been left as a result of debridement surgery.
Skin grafts can also be used after the wound has healed in order to improve the aesthetic appearance. Indeed, patients who have survived necrotising fasciitis often feel very upset by the appearance of the wound and skin grafts can help to reduce the scarring.
Delay in treatment
Necrotising fasciitis is both fast-moving and destructive. Sometimes a patient will have suffered extensive tissue damage by the time he/she reaches a hospital. Other times a patient will be subject to a delay in diagnosis and treatment, leaving time for more and more tissue to become necrotic.
If you have suffered extensive tissue necrosis because of a delay in diagnosis and treatment, you may have grounds for a medical negligence claim.
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