A 53-years-old male patient was presented to our department with a massive hand phlegmon arising from a small skin lesion a week earlier. Despite the swelling, redness and pain, necrotic areas were also present. However, due to chronic hepatitis C the patient was immunocompromised with interferon and ribavirin therapy. After performing a first debridement with necrectomy of the affected skin and soft tissue, vacuum therapy was applied. After several debridements with finally sufficient granulation, we decided to cover the defect by performing a radial forearm flap. This procedure could be successfully done after another period of vacuum therapy as the patient suffered from ascites and his general health conditions worsened due to his liver cirrhosis. The patient could finally be discharged after 7 weeks with good wound healing and recovery from the ascites.
A 46-year-old male was presented to us with the fatal diagnosis of Fournier’s gangrene after receiving his first episodes of chemotherapy comprising of vincristine and prednisone due to a non-Hodgkin lymphoma. After an immediate debridement of the necrotic scrotal area reconstructive surgery was performed already two days later with loco-regional flaps from both sides. With good wound healing and stabilized overall condition, the patient could be discharged to rehab after being hospitalized for more than 12 weeks.