Ischemic through-and-through necrosis of the lateral wall of the torso and inguinal region subsequent to flame injury and septic shock: a case report and literature review.

Post-burn infections still stand as the most common/serious complication of burn injuries: sepsis accounts for 50-60% of deaths in burn patients despite improvements in antimicrobial therapies. Among the many potential complications of sepsis/septic shock are hemodynamic instability and perfusion failure. We report the case of a patient developing massive soft tissue necrosis after an episode of acute post-burn septic shock, with possible explanation of an overdosage of vasopressors due to significant body weight increase as an effect of the burn resuscitation. The utility of vasopressor agents in the management of septic shock depends on the balance between increased perfusion pressure and the direct effect on the microvasculature. The almost inevitable body weight increase in the acute post-burn phase as an effect of the resuscitation makes this balance more difficult to maintain.