抄録
Body lipomodeling, which integrates liposuction and fat grafting across multiple anatomical regions, is one of the most frequently performed aesthetic procedures worldwide. Although its safety profile is generally acceptable, infrequent but potentially severe complications may arise, including fat necrosis of the lower limbs. This report describes a clinically exceptional case of extensive fat necrosis of the right lower limb following gluteal lipomodeling in a 19-year-old woman, complicated by an invasive multisensitive Streptococcus pyogenes infection, severe progressive tissue loss, and secondary anemia, a combination with no close precedent in the relevant literature. This case is notable for its complete resolution through a structured ambulatory management strategy without flap reconstruction or repeat hospitalization. Management included early radical surgical debridement, sequential wound care using ionic silver-impregnated hydrofiber® dressings with anti-biofilm technology, perilesional skin protection, and subsequent ambulatory negative-pressure wound therapy. Longitudinal follow-up over four months documented complete wound closure by secondary intention without recurrence of infection. This case highlights that timely diagnosis and a stepwise therapeutic approach, combining radical debridement, targeted antimicrobial control, and advanced wound care, can achieve favorable outcomes in extensive complicated fat necrosis following body lipomodeling, even in the context of delayed presentation and multiple adverse prognostic factors.
Ambulatory negative-pressure wound therapy (NPWT) application process
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(A) portable NPWT system; (B) placement of a primary foam dressing with Hydrofiber® technology (sodium carboxymethylcellulose) and silicone borders; (C) application of fixation strips to enhance negative pressure; and (D) connection and activation of the portable pump delivering continuous negative pressure at 80 mmHg (month 3).
