Introduction: Necrotizing fasciitis (NF) is a rare, rapidly progressive soft-tissue infection requiring emergent surgical intervention. Upper extremity involvement poses unique reconstructive challenges due to a thin, soft-tissue coverage and risk of tendon exposure. Case Report: We present the case of a 68-year-old female with NF of the left forearm and hand, treated with three debridements followed by split-thickness skin grafting on hospital day 6. A combination of meshed and unmeshed grafts was used, with the unmeshed graft placed over the dorsum of the hand for improved cosmesis. The patient demonstrated excellent graft uptake and preserved hand function at long-term follow-up. This case highlights the feasibility of early grafting in sensitive areas with NF when adequate source control is achieved. Conclusion: Early skin grafting, when carefully timed, can result in favorable functional and esthetic outcomes in complex upper extremity infections.
Porter et al. (Thu,) studied this question.