Surgery 2026

Necrotising fasciitis (NEF), commonly known as flesh eating bacteria, is a near fatal soft tissue infection that poses a challenge to surgeons all over the world, making it a medical and surgical emergency. This rapidly progressing condition spreads along fascial plane and is often missed due to non-specific signs and symptoms that change over time, having a high mortality. Early diagnosis, radical debridement, intravenous antibiotics and rehabilitation are mainstay of treatment. However, despite radical initial surgical debridement and a limb amputation, surgical control of the infectious source is often not achieved resulting into high mortality. It is very rare and unfortunate to get simultaneous infections in all four limb as well as infections in groin and abdomen which poses a great challenge in total care of the patient especially in deciding the depth and breadth of the sequential debridement and clinical decision of limb reconstruction with tissue coverage v/s amputation. I present a case of NEC of a young lady, known IVDU, who presented with high qSOFA score and rapidly spreading oedema and haemorrhagic blisters involvement of all four limbs, groin and abdomen. After serial debridements and Lisfranc amputation, she was successfully stepped down from ICU with using newer modalities of treatment which have not been used frequently all over the world yet and was even discharged home within a 6wks. From our case here, I would like to highlight the urgency of early debridement and use newer treatment modalities with which we could save her life eventually including VAC and honey.

Ms Shreya Sengupta completed MBBS and graduated in 2019 from R. G Kar Medical College and Hospital, Kolkata, India. During her MBBS, she received honours in all the

years of curriculum and gold medal in surgery. She is an ATLS provider and served as

front liner for COVID 19 pandemic in India as ICU doctor and thereafter worked at Medway NHS foundation trust and Frimley park hospital in England as trust doctor for 2 years in general surgery, trauma and orthopedics. She completed her MRCS in 2022 and currently is a core surgical trainee specializing in plastic surgery at Belfast, Northern Ireland. She is also ASIT silver scissors nominee for 2023.