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CC BY-NC-ND 4.0 · Indian J Plast Surg 2023; 56(05): 466-469
DOI: 10.1055/s-0043-1773770
Case Report

Wound Coverage in Extensive Necrotizing Fasciitis with Chronic Liver Disease

M. Choundappan 
1   Department of Plastic and Reconstructive Surgery, Tirunelveli Medical College, Tirunelveli, Tamil Nadu, India
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Abstract

Chronic liver disease is characterized by lowered immunity, altered hematological parameters, and poor wound healing. Surgeons may hesitate to intervene in such patients when they present with necrotizing fasciitis (NF) or misinform the patients regarding their chances of survival. This is because of the poor nutritional state, thrombocytopaenia, and abnormal coagulation profile. However, recent guidelines show that platelet count and prothrombin time/international normalized ratio (PT-INR) do not predict postoperative bleeding. We can proceed with debridement followed by skin grafting of wounds in such patients. This will help reduce the high mortality rate of NF in cirrhotic patients.

Keywords

skin grafting - thrombocytopenia - wound debridement - child-pugh score


Publication History

Article published online:
26 September 2023

© 2023. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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