Managing necrotizing soft tissue infections of the lower limb: microsurgical reconstruction and hospital resource demands
Microsurgical case series published in Journal of Clinical Medicine (2025)
Abstract
Background: Necrotizing soft tissue infections (NSTIs) of the lower extremities represent a surgical emergency with high morbidity, complex reconstruction, and considerable healthcare demands. Free tissue transfer (FTT) is increasingly utilized for limb salvage in extensive soft tissue defects, yet its implications for hospital resource utilization remain unclear. This study aims to compare clinical outcomes and perioperative resource demands between FTT and local flap (LF) reconstruction in NSTI patients. Methods: A retrospective case series was conducted at a tertiary referral center between September 2022 and January 2025, including eight patients with NSTI of the lower extremity (FTT, n = 4; LF, n = 4). Demographic data, comorbidities, surgical timing, complication profiles, and resource utilization metrics-including operative duration, hospitalization length, and number of procedures-were analyzed. All FTT cases underwent preoperative CT angiography as part of institutional protocol. Results: Mean time to definitive reconstruction was longer in the FTT group (17.25 vs. 8 days, p = 0.15), reflecting staged infection control. FTT procedures demonstrated significantly longer operative times (331.75 vs. 170.25 minutes, p = 0.015), but there was no significant difference in total hospital stay (34.75 vs. 27.71 days, p = 0.65). No cases of flap loss or venous congestion were observed, and outcomes were optimized via delayed dangling protocols. Conclusions: FTT is a viable and effective reconstructive modality for lower extremity NSTIs. Despite increased surgical complexity, FTT did not significantly increase hospital resource utilization, supporting its role in limb preservation among appropriately selected patients.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Tertiary-center case series of necrotizing soft-tissue infection lower-limb reconstruction including microsurgical flap salvage with MLT for venous congestion.
Por qué esto importa para la hirudoterapia
This retrospective case series compared free tissue transfer versus local flap reconstruction in eight patients with lower extremity necrotizing soft tissue infections, finding that free tissue transfer was viable with longer operative times but no significant increase in total hospital stay, and no flap loss or venous congestion occurred. This study makes no mention of leech therapy, leech extracts, or the leech secretome. The relevance to ASH's domain is negligible. Although the study discusses soft tissue reconstruction—a field where leech therapy is sometimes applied—the abstract contains no data, findings, or discussion pertinent to hirudotherapy or leech biology.
Citación
Managing necrotizing soft tissue infections of the lower limb: microsurgical reconstruction and hospital resource demands.
Karamitros G et al. · Journal of clinical medicine, 2025
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: June 18, 2026