Lower limb salvage in necrotizing burn wound infection: The role of fibular ostectomy and local flaps in a resource-limited setting - A case report and literature review

INTRODUCTION: Necrotizing burn wound infections following burn injuries are rare. Literature on these cases is also scarce. These infections are life- and limb- threatening unless properly managed. They also pose significant reconstructive challenge, especially in settings lacking microvascular capability. This report describes a limb preservation strategy for limb-threatening necrotizing infection of the leg that complicated a burn injury. Innovative approach was used, utilizing proximal fibular ostectomy, bipedicled local advancement flap and split thickness skin graft. CASE PRESENTATION: A 26-year-old female patient presented to our burn unit after sustaining a contact burn injury from a burning charcoal to her right lateral leg within three days. On the second day of admission, the patient developed significant changes in the appearance of the wound, leading to the diagnosis of necrotizing myofacitis. Emergent debridements were done with the aim of preserving the limb. Subsequent successful, albeit sub-optimal, reconstruction was also achieved despite the lack of microvascular surgical capability in the burn unit. DISCUSSION: This case report and literature review describes a rare limb-threatening necrotizing burn wound infection. The significant reconstructive challenge posed by the defect was addressed using a simple but rarely described reconstructive technique. The importance of limb preservation in LMIC is also emphasized. CONCLUSION: The goal of preserving a limb can be met by using a simple reconstructive technique, despite the lack of microvascular capabilities.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Peer-reviewed clinical and outcomes research relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.

Explore how this research connects to clinical practice

More peer-reviewed studies in Clinical Trials.

• Leech Therapy for Knee Osteoarthritis — The Landmark RCT — Michalsen et al. (2003)
• Leech-Assisted Flap Salvage — Systematic Review of 277 Cases — Whitaker et al. (2012)
• Effects of hirudotherapy on liver functions, lipid profile, and insulin sensitivity in rats with metabolic syndrome — Bilden A et al. (2026)
• HIRUDOTHERAPY IN PRESBYACUZIS PRAECOX IN CLEAN-UP WORKERS AFTER THE CHORNOBYL ACCIDENT DURING THE POST-CATASTROPHE YEARS — Zabolotnyi D, Mishchanchuk N (2019)
• Wound healing potential of bark paste of Pongamia pinnata along with hirudotherapy: A case report — Balasooriya D, Karunarathna C, Uluwaduge I (2021)
• AIF-1 and RNASET2 Play Complementary Roles in the Innate Immune Response of Medicinal Leech — Baranzini N et al. (2019)
• Study on the effect of medicinal leech therapy (Hirudo medicinalis) on full-thickness excisional wound healing in the animal model — Zakian A et al. (2022)
• [Hirudo medicinalis-leech applications in plastic and reconstructive microsurgery--a literature review] — Knobloch K et al. (2007)
• The duration of rest and feeding greatly affects the re-breeding of ectoparasites: Hirudo verbana, Hirudo medicinalis and Hirudo orientalis — Aminov R, Frolov A, Aminova A (2022)
• Recombinant hirudin in clinical practice: focus on lepirudin — Greinacher A, Lubenow N (2001)

Browse all ASH-analysed research →