A 25-year-old male with colitis ulcerosa treated with prednisone was transferred to our department with a soft tissue defect at the left neck and upper left thorax after local necrosis following an abscess due to an erroneous puncture of a central line (Figure 2a ). After several debridements, applying vacuum- and antibiotic therapy combined with continuing a low dose prednisone therapy, the wound was vital and microbiologically free of bacteria. As reconstructive surgery, we decided to perform a supraclavicular artery island flap. The postoperative wound healing process showed no signs of infection with only a minor dehiscence at the drainage area so that we could discharge the patient with a good reconstructive result (Figure 2b ).\nHowever, following the necessity of increasing the prednisone therapy due to an acute period of colitis ulcerosa, the patient presented himself again 3 weeks after being discharged with multiple dehiscence around the elevation site of the supraclavicular flap with serous outflow. The microbiological tests showed no evidence of bacteria. After multiple debridements, the secondary wound was covered with skin grafts using MatriDerm® as dermal matrix (Figure 2c, d ). The young, immunocompromised patient could finally be discharged after an overall hospitalization stay of more than 12 weeks.
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.