How I Treat: Gluteal Necrotizing Soft Tissue Infection Case Presentation

• 54-Year-old female
• Past medical history included: hypertension, hyperlipidemia, morbid obesity (BMI 45)
• The patient presented to the emergency room with a perirectal abscess that had progressed to a necrotizing soft tissue infection of the right gluteus (Figure 1)
• The infection tracked posterior to the rectum and into the retroperitoneum space which required intra-abdominal surgical soft tissue and muscle debridement’s
• Resultant gluteal wound (20 cm x 15 cm x 10 cm) and abdominal wound (25 cm x 5 cm x 4 cm) both required reconstruction

• After the infection was controlled through adequate debridement, Myriad Matrix 3-layer (10 x 20 cm) was applied to both the abdominal and gluteal wounds dry and rehydrated in situ with a saline flush (abdominal wound shown post-debridement and with Myriad placed dry (Figures 2 and 3, respectively).
• A Xeroform® contact layer was placed over the top followed by NPWT. The NPWT dressing was changed every 5 days and was utilized for the initial 5 weeks post operative

• At 5 weeks, both wounds had significantly reduced in size and depth. Healthy granulation tissue was visible in the wound bed and drainage was minimal with no purulence observed (gluteal wound shown in Figure 4)

• At 9 weeks, the gluteal wound was fully healed, and the resulting soft tissue was soft and pliable. The abdominal wound was 95% healed with significant improvement in the inferior portion (Figures 5 and 6)

• A single application of the Myriad Matrix graft facilitated volumetric infill of pliable soft tissue
• Coverage of the exposed wound base with Myriad Matrix helped reduce pain, decrease dressing changes, and therefore reduced patient discomfort compared to dressings requiring daily changes
• Application of Myriad Matrix helped reduce nursing care due to weekly instead of daily dressing changes

• This case report highlights how the addition of Myriad Matrix can aid the rate of healing and closure via the formation of new dermal tissue and facilitation of epithelialization
• The healed wounds demonstrated good cosmesis with soft, pliable and functional tissue

Myriad Matrix™ is a trademark of Aroa Biosurgery Limited.

Dr. Register has a consultancy agreement with Aroa Biosurgery Limited.

April 2022 | MKT.1798.00