Three cases of full recovery after minimal debridement in necrotizing fasciitis

Here, we report 3 cases of necrotizing fasciitis that were successfully treated by minimal surgical debridement. Case 1: a 73-year-old woman had bruised her right hand, and redness rapidly spread to the right upper arm. Initial debridement was performed on her right hand, and administration of an antibiotic was started. The redness and fever diminished in 10 days. Case 2: a 39-year-old man was admitted to our hospital because of purpura and necrosis accompanied by tenderness over a wide area from the right knee to the thigh. Since he also had severe diabetes, we limited initial debridement by incision only to the markedly necrotic site. The inflammatory response was improved after the administration of an antibiotic and strict general care for a few days. Case 3: a 73-year-old man was aware of a swelling of the dorsal side of the right hand since his first visit 2 days before. The swelling and redness rapidly expanded to the entire right upper arm, and he suffered from septic shock. In addition to an incision to his right hand, intensive care including the intravenous administration of antibiotics and endotoxin adsorption therapy were performed. He recovered from septic shock and was fully recovered within a month after admission. In conclusion, proper debridement is required for the treatment of necrotizing fasciitis.