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Current Issue - November 2025, Volume 19, Issue No. 3

Official Journal of Malaysian Orthopaedic Association and ASEAN Orthopaedic Association

Fasciotomy and Debridement in Alpha-Hemolytic Associated Type II Necrotizing Fasciitis of The Hand: A Case Report

Abstract

Necrotizing Fasciitis (NF) is a rare and potentially life-threatening infection affecting the skin and soft tissue. Its incidence is estimated at 4 cases per 100,000 people a year in the United States. Gram-positive cocci are the common causative organism. With a mortality rate of 25% to 35%, it should be diagnosed as soon as possible, and the treatment should be expedited. A 68-year-old woman presented with acute disturbed consciousness, accompanied by fever, swelling, and pain on the index finger of the right hand. She gave a history of a cut finger one day prior. Her index finger appeared pale and cold in touch with no capillary refill time and was insensate. Initially, she was diagnosed with a diabetic hand. With the disease progressivity combined with laboratory and ultrasonography results, she was diagnosed with NF, and emergency debridement and fasciotomy were done. NF is a lethal and fast progressing Skin and Soft Tissue Infections (SSTIs) that should be diagnosed early to reduce the mortality rate. A slower rate of infection does not exclude NF as a diagnosis because many factors can affect it, such as its aetiology, coexisting disease, or our empiric antibiotic. In treating NF, a blood culture should be done to identify its cause, and we should perform adequate surgical debridement with or without fasciotomy based on its manifestations.

Abstract   |   Reference

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The Malaysian Orthopaedic Journal is a peer-reviewed journal that is published three times a year in both print and electronic online version. The purpose of this journal is to publish original research studies, evaluation of current practices and case reports in various subspecialties of orthopaedics and traumatology, as well as associated fields like basic science, biomedical engineering, rehabilitation medicine and nursing.

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