Microvascular reconstruction after extensive cervical necrotizing fasciitis: A case series

Abstract In patients with cervical necrotizing fasciitis undergoing extensive surgical debridement, vascularized reconstruction may be required. Little is known regarding the outcomes for free tissue transfer in the setting of a prior necrotizing infection in the head and neck. A retrospective chart review identified patients treated for cervicofacial necrotizing fasciitis at a single academic tertiary care center between 2008 and 2017. Disease and functional data were collected on patients requiring free tissue transfer. Among 23 patients treated for necrotizing fasciitis of the head and neck, two patients required free tissue transfer (each with an anterolateral thigh free flap) after appropriate control of their infectious process. There were no postoperative complications and both patients recovered well with good functional outcomes. These cases demonstrate that in select patients with extensive cervicofacial soft tissue defects after resolution of necrotizing fasciitis, free tissue transfer may be a safe and viable option