Utilizing Fragmented Acellular Fish Skin Grafts in Management of Large Soft Tissue defects following Necrotizing Fasciitis Debridement

Introduction: Necrotizing fasciitis can often result in extensive soft tissue loss following surgical debridement. Conventional wound management can be ineffective due to the large soft tissue defect that is created. Fragmented acellular fish skin graft provides a novel approach to covering these large soft tissue defects.  Methods: We present the case of a 41-year-old female with no significant past medical history who presented with compartment syndrome and was taken emergently for fasciotomies. During the patient's postoperative course, she developed necrotizing fasciitis and was taken for multiple I&D which resulted in a large soft tissue defect. Once the infection was controlled a total of 2 acellular fish skin grafts were applied with negative pressure wound vac followed by skin graft application. Results: Patients experienced remarkable success following the application of multiple acellular fish skin grafts. The formation of an excellent granular wound base post-application facilitated successful skin grafting, leading to complete wound closure.  Discussion: Acellular fish skin graft emerges as a viable option for addressing large soft tissue defects subsequent to aggressive debridement in cases of necrotizing fasciitis.   References: