2022 Volume 21 Issue 1 Pages 27-33
Case 1 : A 70-year-old man presented with a painful nodule on his right shoulder. The lesion, 30 cm in diameter, was characterized by a dark red necrotic plaque that was surrounded by numerous pus-filled bumps. The patient was diagnosed with a carbuncle, admitted, and treated with infusion antibiotic therapy. On the 13th day after admission, the patient underwent tissue debridement. From the 20th to the 30th day post-admission, he received negative pressure wound therapy with instillation therapy and dwelling time (NPWT-id), followed by a full-thickness skin graft. Eighty days after admission, complete epithelialization had occurred. Case 2 : A 74-year-old man presented with a lesion that was similar to Case 1. A dark red necrotic carbuncle, 23 cm in diameter, was on his left shoulder and was surrounded by numerous pus-lled bumps. After admission, the patient underwent the same treatment plan : antibiotic infusion, debridement, NPWT-id, and a full-thickness skin graft. Eighty days after admission, epithelialization was complete. Previous studies reported that the majority of patients with large carbuncles also had severe diabetes. For this reason,patients with these lesions tend to experience severe symptoms and require early treatment. In recent years, NPWT has become the preferred treatment for large-sized carbuncles. However, the disadvantage of NPWT is that it cannot be performed until the infection is controlled. By including instillation therapy and dwelling time to NPWT, we were able to provide a rapid approach to both wound healing and infection treatment. Both patients experienced wound healing with good granulation tissue formation within a short period of time. NPWT-id is an effective method of treatment for large carbuncles. Skin Research, 21 : 27-33, 2022
