Necrotizing Soft Tissue Infections of the Breast: A Potentially Lethal Surgical Emergency

Abstract

Necrotizing soft tissue infection (NSTI) of the breast is an extremely rare event in surgical practice. It is considered the most aggressive form of soft tissue infection and a true surgical emergency. It is also associated with a high risk of mortality if not diagnosed promptly. Few cases have been documented in the literature; the exact etiology and risk factors vary from those involving the limbs, trunk, and perineum. Early recognition, prompt surgical treatment, and broad-spectrum antibiotic therapy are crucial for reducing morbidity and mortality. These reports present cases of NSTIs in breasts with unique etiologies and challenges in their management.

Necrotizing Breast Infection: A Rare Entity and a Management Challenge

“…The majority of patients require a mastectomy for definitive source control. Partial mastectomy and radical mastectomies have also been performed and described for source control with a second look in 24 -48 h for additional debridement [10,12,13]. All were initially closed by secondary intention or delayed primary closure.…”

“…A vacuumassisted closure (VAC) device dressing can assist with increasing granulation of the wound and can further assist in closure of the wound. The most common method for closure was split thickness skin grafting, although a large proportion also un-dergo delayed primary closure [12,13]. Delayed primary closure was a more likely option in those who underwent partial mastectomy with or without serial debridement.…”

“…Delayed primary closure was a more likely option in those who underwent partial mastectomy with or without serial debridement. Hyperbaric oxygen therapy and use of the Integra bilayer wound matrix can help prepare the wound for future skin grafting [12][13][14]. Local flap advancement, local breast tissue arrangement, and pedicle flap reconstruction have also been described [12,13].…”

“…Hyperbaric oxygen therapy and use of the Integra bilayer wound matrix can help prepare the wound for future skin grafting [12][13][14]. Local flap advancement, local breast tissue arrangement, and pedicle flap reconstruction have also been described [12,13].…”

“…Metastatic disease was likely due to the presence of numerous tracer avid lymph nodes A Case of Necrotizing Breast Infection J Curr Surg. 2024;14(1): [11][12][13][14][15][16] in the right axillary and subpectoral regions. The kidney mass standardized uptake value (SUV) was 3.8, likely a primary renal neoplasm.…”