Physiotherapy Rehabilitation Following Lower Extremity Split Skin Grafting in Necrotizing Fasciitis

Abstract

Necrotizing fasciitis is defined as a highly progressive microbial infection. The diagnosis of necrotizing fasciitis is mostly based on clinical signs, and early diagnosis is key. There are several difficulties that patients confront following surgery. Physical therapy helps to regain the functional range of motion, enhance muscle strength, reduce stiffness and make the patient self-independent. We presented a case of a 54-year-old male with presenting complaints of pain over right lower limb while doing movements and difficulty in performing daily activities. The patient was diagnosed with necrotizing fasciitis of the right leg which was managed surgically by a skin-split graft but later the patient developed post-operative stiffness and pain for which physiotherapy was advised. A goal-oriented tailored rehabilitation approach was planned for the patient for four weeks. The patient and his family were informed about their present condition. Positioning was given to reduce edema. Wound healing was enhanced by the use of ultrasound and low-level laser therapy. In order to mobilize scar myofascial release technique and massage were applied. To increase functional range and strength, a mobility and strengthening exercise was performed. To make the patient functionally independent balance and gait exercise was given. The outcome measures included a numerical pain rating scale (NPRS), range of motion, manual must testing, and lower extremity functional scale. There was an improvement in all the outcome measures taken. The treatment protocol proved to be beneficial for the patient.