Healing Complex Wounds from Necrotizing Fasciitis Using the Combination of Negative Pressure Wound Therapy With Instillation and Dwell Time and a Hypochlorous Acid solution

Necrotizing Fasciitis is a life-threatening infection that can rapidly destroy skin, fat, and generally any tissue that covers muscles. The disease sometimes is called flesh-eating bacteria disease and when it occurs on the genitals, it is called Fournier Gangrene. The bacteria may enter via minor wounds, or surgical wounds, or often via bruises. The condition is rare but serious, and is associated with comorbidities such as diabetes, cancer, immune suppression, liver or kidney disease. Quick diagnosis and treatment including excisional debridement and systemic antibiotic therapy are essential for patient survival. In addition, NPWTi-d (Negative Pressure Wound Therapy with instillation and dwell) has been increasingly used to treat these serious wounds. We report the use of a hypochlorous acid solution* in combination with NPWTi-d, to assist in mechanically removing bacteria and necrotic tissue in the wound bed preparation process and manage the life-threatening infection.
Featured are four case studies where the combination of NPWTi-d with a hypochlorous acid solution as the instillation solution was used to improved clinical outcomes that resulted in wound healing and closure. Each exhibits a complex wound and often a complex patient who was faced with a serious infection that threatened life and limb. Each patient showed clinical improvement when the initiation of NPWTi-d with hypochlorous acid solution in addition to intravenous antibiotics. Each patient survived the medical condition, albeit after long stays in the ICU and stepdown units. We conclude that a pH controlled pure hypochlorous acid solution offers a promising way to manage the life-threatening condition of necrotizing fasciitis, particularly in combination with NPWTi-d

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References (if applicable): 1. Singh G, Bharpoda P, Reddy R. Necrotizing Fasciitis: A Study of 48 Cases. Indian J Surg. 2015;77(Suppl 2):345-350. doi:10.1007/s12262-013-0835-2
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Wound Therapy With Instillation and Dwell Time for Extensive Necrotizing Fasciitis of the Lower Extremity: A Case Report. Cureus: 2018 Oct 23;10(10):e3483. doi: 10.7759/cureus.3483