Microsurgical reconstruction of chest wall defect after necrotizing fasciitis.

Chest wall necrotizing fasciitis is a rare and often fatal infection that usually requires extensive debridements and reconstructive procedures. We describe the therapeutical course of an uncommon case of perforating thoracic wound complicated with necrotizing fasciitis, with consecutive debridements and a resultant full-thickness subscapular defect. We agree that free flaps, although seldom required, must be considered when treating more complex defects. Latissimus dorsi free-flap was enough for pleural reconstruction and wall stabilization. There are no previous references in the literature to primary chest wall fasciitis treated successfully with microsurgical reconstruction. (c) 2006 Wiley-Liss, Inc.