Abstract
A 52-year-old man with untreated diabetes mellitus had a raised purple-red lesion on his right lower back. Blood examination showed remarkable elevation of C-reactive protein level. Emergent incision and drainage of the raised purple-red lesion, surgical debridement, and wound irrigation with a pulsed lavage system were performed under local anesthesia. We diagnosed him with necrotizing fasciitis on the basis of the necrosis of subcutaneous tissue extending to the middle layer of the muscle, as an operative finding. The causative agent was methicillin-sensitive Staphylococcus aureus. Infection control was carried out with a pulsed lavage system and the skin defect with deep pockets diminished using negative pressure wound therapy (NPWT); the wound subsequently healed without a skin graft. We diagnosed this case as a subcutaneous abscess from the clinical course because his skin did not necrotize. This case is rare because it involved a subcutaneous abscess that developed on the back of a patient with untreated diabetes. We had difficulty achieving infection control and wound healing, but pulsed lavage system and NPWT, respectively, were useful for these conditions.Skin Research, 12: 97-102, 2013
