Having Skin in the Game: A Case Study of Necrotizing Fasciitis in the Neonate Treated With Cultured Epidermal Autografts.

BACKGROUND

Necrotizing fasciitis (NF) is a rare but often fatal bacterial infection of the skin and the soft tissue.

CLINICAL FINDINGS: Necrotizing fasciitis occurs mainly in adults and remains relatively uncommon in the neonate. Because the presenting skin and laboratory findings are variable, prompt diagnosis is often difficult. The risk of mortality increases with time to intervention.

PRIMARY DIAGNOSIS: This case presents a 4-day old full-term female neonate with NF resulting in a significant scalp defect.

INTERVENTIONS: The neonate was successfully treated using a novel approach with a cultured epidermal autograft.

OUTCOMES: The treatment period was effective, and the neonate had an excellent clinical outcome. The neonate was discharged home 21 days post graft application.

PURPOSE: This case study will highlight the influence of the clinical nurse specialist on care coordination, innovative treatment plans, and resource development for a neonate with NF.

PRACTICE RECOMMENDATIONS: Because of the rare but fatal nature of NF, innovative therapies must be considered. Offering a nontraditional treatment can help improve patient recovery and long-term outcomes. The use of cultured epidermal autograft now provides a new treatment option for neonatal patients in the future.