A 60-year-old female with the initial diagnosis of acute myelogenous leukemia was presented to our clinic with an abscess and surrounding erysipelas on the left lower leg (Figure 4a ). A first excision and debridement of the soft tissue was performed exposing the extensor tendons with a defect size of 6x5 cm (Figure 4b ). Vacuum therapy was applied. Due to the initial and ongoing chemotherapy (idarubicin and cytosin-arabinoside) with a depleted hematological cell status, we decided not to perform a reconstructive procedure with a loco-regional or even free flap, but to repeat the debridement and vacuum therapy for the following 10 weeks. With a satisfying granulation of the wound, we finally closed the defect with skin grafts during a chemotherapeutic interval (Figure 4c ). Although, the wound healing was prolonged, the patient could be discharged with finally good results to receive further allogenic stem cell transplantation in an external clinic.
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.