Necrotising Soft Tissue Infection (NSTI), an Atypical Complication of Pressure Ulcer: A Case Report

Norashikin Ahmad *

Department of General Surgery, Hospital Segamat, KM 6, Jalan Genuang, 85000 Segamat, Johor, Malaysia.

Aina Nazira Abdul Muttalib

Department of General Surgery, Hospital Segamat, KM 6, Jalan Genuang, 85000 Segamat, Johor, Malaysia.

Mohd Shafiq Rahman

Department of General Surgery, Hospital Segamat, KM 6, Jalan Genuang, 85000 Segamat, Johor, Malaysia.

Yogessvaran Krishnan

Department of General Surgery, Hospital Segamat, KM 6, Jalan Genuang, 85000 Segamat, Johor, Malaysia.

*Author to whom correspondence should be addressed.


Abstract

Introduction: Infected pressure sore, also known as bedsore or pressure ulcer is a very common condition presented to hospitals especially in elderly and bedbound patients with reported incidence rate of 12%. Managing infected bedsore is challenging and involve multidisciplinary care. Unfortunately, despite best possible efforts, infected pressure sore may progress into necrotising soft tissue infection (NSTI).

Case Report: A 73-year-old lady presented to emergency department with infected pressure sore which turned out to be NSTI at gluteal region. She was treated aggressively with broad spectrum antibiotic and underwent multiple surgical debridement.

Conclusion: NSTI arising from pressure sores is rare but has high morbidity and mortality. Early diagnosis and treatment is crucial in handling such cases.

Keywords: Pressure, sore, ulcer, necrotising fasciitis


How to Cite

Ahmad, Norashikin, Aina Nazira Abdul Muttalib, Mohd Shafiq Rahman, and Yogessvaran Krishnan. 2024. “Necrotising Soft Tissue Infection (NSTI), an Atypical Complication of Pressure Ulcer: A Case Report”. Asian Journal of Case Reports in Surgery 7 (1):48-52. https://journalajcrs.com/index.php/AJCRS/article/view/497.

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References

Agrawal K, Chauhan N. Pressure ulcers: Back to the basics. Indian Journal of Plastic Surgery. 2012;45(02):244-254.

Borojeny LA, Albatineh AN, Dehkordi AH, Gheshlagh RG. The incidence of pressure ulcers and its associations in different wards of the hospital: A systematic review and meta-analysis. International Journal of Preventive Medicine. 2020;11.

Tai Li Ling, Lim Chew Har, Mohd Ridhwan Mohd Nor, Nahla Irtiza Ismail, Wan Nasrudin Wan Ismail. Malaysian Registry of Intensive Care report; 2017.

European pressure ulcer advisory panel and national pressure ulcer advisory panel. Prevention and treatment of pressure ulcers: Quick reference guide. Washington DC: National Pressure Ulcer Advisory Panel; 2009.

Wallace HA, Perera TB. Necrotizing fasciitis; 2017.

Misiakos EP. et al. Current concepts in the management of necrotizing fasciitis, Frontiers in surgery; 2014. Available:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4286984/ (Accessed: 02 August 2023).

Tantirat P, Rattanathumsakul T, Praekunatham H, Pachanee K, Suphanchaimat R. Epidemiological situation of necrotizing fasciitis and factors in Thailand and factors associated with its morbidity and mortality, 2014–2018. Risk Management and Healthcare Policy. 2020;1613-1624.

Esayag Y, Brautbar A, Popov A, Wiener-Well Y. Necrotizing soft tissue infection: An unusual and devastating complication of pressure sores. The Israel Medical Association Journal: IMAJ. 2011;13(7): 442-443.

Citak M, Backhaus M, Tilkorn DJ, O'loughlin PF, Meindl R, Muhr G, Fehmer T, Falcone M, Tiseo G. (2023). Skin and soft tissue infections in the elderly. Current Opinion in Infectious Diseases. 2011;36 (2):102-108.

National clinical guideline centre (UK). The Prevention and management of pressure ulcers in primary and secondary care. London: National Institute for Health and Care Excellence (NICE); (NICE Clinical Guidelines, No. 179.) Barrier creams. 2014; 14.

Young JB. Aids to prevent pressure sores. BMJ: British Medical Journal. 1990;300 (6730):1002.

Mizokami F, Furuta K, Isogai Z. Necrotizing soft tissue infections developing from pressure ulcers. Journal of Tissue Viability. 2014;23(1):1-6.