(CS-010) Use of collagen alginate dressing in conjunction with Gentian violet/Methylene Blue pre-moisten Wide-cell Polyvinyl Alcohol anti-bacterial foam in the treatment of wounds with Necrotizing Fasciitis – Case Studies

As sited in several wound care journals, Necrotizing fasciitis (NF) is a complex disease that poses a severe threat to tissue viability. Prompt and multifaceted approach to wound management is crucial and can also be vital for the patient’s clinical outcome.  This case series evaluated the efficacy of early treatment using a Collagen alginate (CA) dressing in combination with a (GV/MB) pre-moisten wide-cell PVA antibacterial foam on wounds that had the NF diagnosis and exposed tendon. 

NECROTIZING FASCITIS (NF) are rare but rapidly progressive, life-threatening bacterial infections that can destroy the epidermis, dermis, subcutaneous tissue, fascia, and muscle.^1-4 Patients with certain comorbidities such as diabetes are at a higher risk for NF. Prompt recognition of signs and symptoms, targeted diagnostic testing, and timely treatment are crucial to avoid poor patient outcomes, including sepsis, amputation, and death.²

Surgery is the gold standard treatment when NF is either suspected or diagnosed. Surgical exploration and debridement of the affected tissue should be performed promptly. Initial tissue findings may include discoloration, gross edema or ecchymosis, and signs of necrosis. Specimens for Gram stain and culture should be obtained during surgical exploration.¹³ Amputation may be required to manage the infection in severe cases involving the extremities.

Methods:

In the treatment of NF, this case series demonstrated that using the combination of the CA dressing and GV/MB pre-moisten wide-cell PVA was effective in aiding the formation of granulation tissue over exposed tendon. Within a 72 hour of utilization of the dressing combination, 80% of the exposed tendon was covered with healthy granulation tissue.

Results:

In this case series, utilization of the combination of the collagen alginate dressing  and GV/MB pre-moisten wide-cell PVA in the treatment of NF aided in the in promoting healthy granulation tissue with positive patient outcomes. Furthermore, due to limited case series, additional research will be required.

Discussion: There are clinical options that are available to combat the complications of necrotizing fascitis including tissue viability.  This combination therapy assisted with granulation tissue formation.