Negative Pressure Wound Therapy for Gas Gangrene of the Fingertip with Prolonged Infection

Yasufumi Okamoto; Kazuhiro Maeda; Mitsuhito Yukawa; Reiji Nishimura; Yuji Nagamine; Yuka Hadano; Ayano Mandai; Jun Udaka; Takeshi Miyawaki; Mitsuru Saito

doi:10.1097/GOX.0000000000005782

Negative Pressure Wound Therapy for Gas Gangrene of the Fingertip with Prolonged Infection

Plast Reconstr Surg Glob Open. 2024 May 1;12(5):e5782. doi: 10.1097/GOX.0000000000005782. eCollection 2024 May.

Authors

Yasufumi Okamoto¹, Kazuhiro Maeda^{1

2}, Mitsuhito Yukawa^{1

2}, Reiji Nishimura^{2

3}, Yuji Nagamine^{1

2}, Yuka Hadano^{1

2}, Ayano Mandai^{1

2}, Jun Udaka⁴, Takeshi Miyawaki³, Mitsuru Saito¹

Affiliations

¹ From the Department of Orthopaedic Surgery, The Jikei University School of Medicine, Tokyo, Japan.
² Hand Surgery Center, The Jikei University Hospital, Tokyo, Japan.
³ Department of Plastic and Reconstructive Surgery, The Jikei University School of Medicine, Tokyo, Japan.
⁴ Tetsujikai Medical Corporation Kasuga Clinic, Hiroshima, Japan.

Abstract

Background: We encountered a case of infected soft tissue defect of the fingertip treated using negative pressure wound therapy (NPWT). The development of NPWT was started in the early 1990s, and it is a relatively new treatment method included in insurance coverage in Japan in 2010. NPWT is used for intractable wounds; some reports have examined its use on infected wounds. However, to the best of our knowledge, no study has examined its use on infected fingertip wounds.

Methods: A patient with an infected soft tissue defect in the fingertip whose epithelialization period was prolonged despite continued antibiotic therapy was treated using NPWT in combination.

Results: After NPWT was started, signs of infection and wound granulation were good. Additionally, completion of epithelialization was confirmed 7 weeks after NPWT started.

Conclusions: Conventionally, skin flap or graft by hand surgeons have been performed on fingertip soft tissue defects with infection. NPWT does not require specialized and advanced surgical techniques; treatment for infected soft tissue defects can be administered by anyone if they have the required skills. In conclusion, NPWT may be considered a suitable alternative when treatment options such as flaps and skin grafts are not feasible.