Large flap preservation in a patient with extensive necrotizing fasciitis: is vertical transmission of infection directly proportional to centrifugal spread of disease? .

Necrotizing fasciitis is a rare yet rapidly progressive life-threatening soft tissue infection. Historically, radical excision (including skin) along with broad-spectrum antibiotics has been the treatment regimen of choice. The authors report a patient treated in the burn unit with extensive necrotizing fasciitis in whom large skin flap preservation was achieved. The staple treatment of necrotizing fasciitis is early recognition, diagnosis, and complete necrosectomy. This process often leads to unnecessary resection of all overlying skin beyond the sentinel region of infection. To the authors' knowledge, the preservation of large skin flaps in patients with necrotizing fasciitis has not been reported in the literature. .