Meek Micrografting Technique for Reconstruction of Extensive Necrotizing Fasciitis of the Anterior Abdomen and Bilateral Femoral Region: A Case Report

Abstract

Necrotizing fasciitis is an uncommon yet fatal soft tissue infection. Current recommended treatment includes antibiotics with repeat surgical exploration and wound debridement followed by reconstruction. In burn patients, the Meek micrograft has demonstrated a higher true expansion ratio, faster reepithelialization rate, more resilient toward infection, and reduced risk of graft failure as compared with meshed graft. To our best knowledge, the use of Meek micrografting technique in reconstruction of postdebridement wounds of necrotizing fasciitis has not been reported. Hereby, we present a case of a 57-year-old gentleman who was referred to us for wound reconstruction after surgical debridement of Fournier's gangrene and extensive necrotizing fasciitis involving the anterior abdomen and bilateral femoral region. Meek micrografting technique was used to reconstruct the anterior abdomen as the wound bed was large. Although the graft was complicated with a small area of localized infection, it did not spread across the entire graft and was successfully treated with topical antibiotics and regular wound dressing. In our case, wound reconstruction using Meek micrografting technique in a patient with extensive necrotizing fasciitis was successful and showed positive outcome. Therefore, we suggest further studies to be conducted to investigate the applications and outcomes of the Meek micrografting technique, especially in patients with extensive wound bed and limited donor site availability.

Keywords

necrotizing fasciitis - reconstructive surgery - skin transplantation - skin graft

Authors' Contributions

Substantial contribution to the conception and design of the work: J.C.N. and J.D.L. under the guidance of A.I.A.Z. and M.F.J. Drafting the work and critical revision: J.C.N. and J.D.L. under the guidance of A.I.A.Z. and M.F.J. All the authors read and approved the final version of the manuscript.

Ethical Approval

This study was performed in accordance with the principles of the Declaration of Helsinki.

Patient Consent

Written consent was obtained from the patient for the publication of images or data related to the patient.

Note

This work was presented at the 48th Annual Scientific Congress of the College of Surgeons Malaysia, August 27, 2022.

Publication History

Received: 19 October 2022

Accepted: 28 March 2023

Accepted Manuscript online:
19 April 2023

Article published online:
24 August 2023

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