Staged Comprehensive Management for Necrotizing Fasciitis of the Lower Extremity with Sepsis: A Case Report

Necrotizing fasciitis is a severe soft tissue infection characterized by rapid necrosis of the skin, subcutaneous tissue, and fascia. Its onset is sudden, and progress is rapid. Complications such as sepsis, septic shock, and multiple organ dysfunction syndrome (MODS) can appear early, leading to high mortality and disability. The early symptoms lack specificity, posing diagnostic challenges and a high risk of misdiagnosis. This case report describes a 37-year-old male patient who presented with progressive redness, swelling, and pain of the left lower limb. Bedside incision and exploration under local anesthesia confirmed acute necrotizing fasciitis. Staged comprehensive management included early surgical debridement, empirical antibiotics, anti‑shock therapy, vacuum sealing drainage, and eventual skin grafting. The patient's limb was salvaged, and at 1-year follow-up, he had returned to normal daily activities. This case may provide limited insights for the clinical management of similar patients, particularly regarding the importance of timely bedside exploration and a multidisciplinary, staged approach.