J Acute Care Surg.  2024 Nov;14(3):113-117. 10.17479/jacs.2024.14.3.113.

Usefulness of Noninvasive Ventilation with Negative-Pressure Wound Therapy in the Intensive Care Unit: A Case Report

• Choi D
• Jang JY
• Park K
• Lee KY
• Yun H
• Lee S

• KMID: 2561029
• DOI: http://doi.org/10.17479/jacs.2024.14.3.113

Abstract

Fournier’s gangrene is infectious, necrotizing, life-threatening fasciitis of the perineal, genital, and perianal regions leading to soft-tissue necrosis and sepsis, and is treated with aggressive surgical debridement and antimicrobial agents. Negative-pressure wound therapy can be used if septic risk is controlled. An 82-year-old woman presented with Fournier’s gangrene and septic shock. After emergency debridement, perineal resection, a colostomy, and daily wound debridement was performed under general anesthesia (1 week). Multiple intubations and extubations under general anesthesia are a risk factor for poor patient outcomes. Therefore, negative-pressure wound therapy was performed under light sedation using noninvasive ventilation in the intensive care unit after extubation and for wound debridement. One month later, the perineum was reconstructed. Procedures performed under light sedation should be considered for patients requiring periodic invasive surgical procedures who are burdened by repeated general anesthesia. The number of general anesthesia sessions was significantly reduced by using noninvasive ventilation.

Keyword

Fournier’s gangrene, negative-pressure wound therapy, noninvasive ventilation, surgical procedure