Necrotizing fasciitis is a life-threatening infection that can rapidly destroy skin, fat, and any tissue that covers muscle. It is sometimes called flesh-eating bacteria disease and, when it occurs on the genitals, Fournier gangrene. Bacteria may enter via minor wounds, surgical wounds, or bruises. The condition is rare but serious, and is associated with comorbidities such as diabetes, cancer, immune suppression, and liver or kidney disease. Quick diagnosis and treatment, including excisional debridement and systemic antibiotics, are essential for patient survival.1,2 Negative pressure wound therapy with instillation and dwell (NPWTi-d) (V.A.C. Veraflo; 3M+KCI) has increasingly been used to treat these wounds.3 This case series highlights a hypochlorous acid solution (Vashe Wound Solution; Urgo Medical North America) in combination with NPWTi-d to assist in mechanically removing bacteria and necrotic tissue in the wound bed preparation process and manage the infection.
A retrospective chart review was performed to obtain patient information. All patients received systemic antibiotics in addition to prescribed wound therapy, underwent debridement as necessary, were treated with NPWTi-d, instilling hypochlorous acid solution during wound treatment, and had dressings changed at 48- to 72-hour intervals.