Abstract
We described our experience with a case of necrotizing fasciitis accompanied with broad necrosis of cervical skin caused by acute osteoradiomyelitis.
A 60-year-old man was referred to our hospital because of swelling and pain of the submandibular region. He had undergone radical surgery for maxillary gingival squamous cell carcinoma and radiation therapy a year before. On the basis of imaging findings and clinical course, osteoradiomyelitis and necrotizing fasciitis were diagnosed, and surgical and chemical debridement was performed. After chemical debridement was performed on strongly attached black scar tissue in the neck, reconstruction of the skin defect was performed by pectoralis major myocutaneous flap and split-thickness skin grafting. Moreover, because of DIC and internal jugular vein thrombosis with distant infection comorbidity and clinical findings revealed Lemierre’s syndrome, we performed anticoagulant therapy additionally. Our experience shows that time to reconstruction and treatment of scar tissue in the neck are controversial.
