Necrotizing fasciitis (NF) is a rapidly progressive necrosis of the subcutaneous tissue and fascia, caused by bacterial infection. Usually presenting in the extremities, trunk, or perineum, it is uncommon in the craniofacial or cervical area. Cervicofacial NF is a potentially fatal infection, which should be managed with early detection and intervention. Most cases have a primary odontogenic source of infection, especially when the masticator space is involved. We report a case of masticator space NF that developed without odontogenic origin in a 78-year old female who was treated with prompt surgical drainage and intravenous antibiotics.
Anti-Bacterial Agents ; Bacterial Infections ; Drainage ; Extremities ; Fascia ; Fasciitis, Necrotizing ; Female ; Humans ; Mandible ; Mouth, Edentulous ; Necrosis ; Osteomyelitis ; Perineum ; Subcutaneous Tissue

A post-burn scar contracture (PBSC) can cause functional problems including limited range of motion (ROM) and, in turn, poor quality of life. We present a case with an extensive PBSC combined with chronic ulceration. Treatment involved scar tissue excision, rehabilitation, and delayed reconstruction using a free transverse rectus abdominis myocutaneous flap and a split-thickness skin graft. After scar tissue excision, negative pressure was applied to the open wound; this facilitated rapid ambulation and ROM recovery within 2 weeks. Ultimately, over 6 months, the initial flexion contracture of 60º improved to 10º, and the ROM improved from 75º to 125º.