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
Esta serie de casos retrospectiva comparó la transferencia libre de tejido frente a la reconstrucción con colgajo local en ocho pacientes con infecciones necrotizantes de tejidos blandos de la extremidad inferior, encontrando que la transferencia libre de tejido era viable con tiempos quirúrgicos más prolongados, pero sin un aumento significativo de la estancia hospitalaria total, y no se produjeron pérdidas del colgajo ni congestión venosa. Este estudio no menciona la terapia con sanguijuelas, los extractos de sanguijuela ni el secretoma de la sanguijuela. La relevancia para el ámbito de ASH es negligible. Aunque el estudio aborda la reconstrucción de tejidos blandos —un campo en el que a veces se aplica la terapia con sanguijuelas—, el resumen no contiene datos, hallazgos ni discusiones pertinentes a la hirudoterapia o la biología de la sanguijuela.
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
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026