pre OP DX: Necrotizing Fasciitis, left upper extremity

Post-OP DX: Solvent induced necrosis, left arm from forearm to axilla

Procedure: Debridement and irrigation, application of wound vac, left upper extremity.

(I am just summarizing the procedure here)Patient was taken into the OR, prepped and draped. An extensive Henry approach was utilized. Incision was taken transversely across the antecubital fossa. Exploration demonstrated fat necrosis. Fat and fatty tissue was liquefied consistent with saponification. The incision was extended up the arm with a strong odor of paint thinner within the muscular layer. The incision was taken up to the axilla in a deltopectoral manner. Debridement took place of all of the tissues. Vessel loops and staples were used to construct elastic skin closure. The remaining on half to three quarter inch separation of the skin was covered with foam and a wound vac.
Plans were made to do a re-debridement in 2 days.

Your help would be muchly appreciated!