This case illustrates the difficulty in diagnosis. The patient is an obese diabetic. Her problem started as a small sore and started to drain.

Photos courtesy of Deborah Bartholomew, MD.

This case illustrates the difficulty in diagnosis. The patient is an obese diabetic. Her problem started as a small sore and started to drain.

Photos courtesy of Deborah Bartholomew, MD.

This case illustrates the need for aggressive debridement. The patient is an obese diabetic. Her problem started as a small sore and started to drain. This picture shows the need to resect until clean, bleeding tissue is obtained. Devitalized tissue is seen deep in the wound, as is bone.

Photos courtesy of Deborah Bartholomew, MD.

This case illustrates the need for aggressive debridement. The patient is an obese diabetic. Her problem started as a small sore and started to drain. This picture shows the final extent of the dissection required. She was in the ICU for quite some time, was treated with broad spectrum antibiotics and a wound vac. The wound retracted but eventually she got a split thickness skin graft.

Photos courtesy of Deborah Bartholomew, MD.

Deep debridement is necessary in the treatment of necrotizing fasciitis.

Photos courtesy of Deborah Bartholomew, MD.

Deep debridement is necessary in the treatment of necrotizing fasciitis.

Photos courtesy of Deborah Bartholomew, MD.