Necrotising fasciitis following abdominoplasty performed abroad: a case report

Cosmetic medical tourism has grown considerably in Europe, with many patients travelling abroad seeking lower-cost procedures. However, heterogeneous practices and the absence of postoperative follow-up inherent to geographical distance may lead to life-threatening complications with delayed management. We report a case of necrotising fasciitis following abdominoplasty performed abroad.

A 42-year-old female patient underwent abdominoplasty, liposuction, and gluteal lipofilling in a foreign country. The postoperative course was complicated by anaemia, wound dehiscence, and an inflammatory syndrome, initially managed conservatively. Her condition deteriorated, necessitating medical repatriation. On admission, clinical examination revealed abdominal soft tissue necrosis with fever and purulent discharge, alongside a severe inflammatory response on laboratory investigations. Emergency surgical exploration confirmed extensive necrosis of the abdominal fascia and a gluteal collection. Wide debridement with bacteriological sampling and drainage were performed. Empirical broad-spectrum antibiotic therapy was initiated, and postoperative vasopressor support was required. An early second-look procedure was performed the following day. Following vacuum-assisted closure (VAC) therapy, reconstruction with a split-thickness skin graft was carried out. The patient was discharged after six weeks of hospitalisation with significant aesthetic sequelae.

Necrotising fasciitis is a rare but potentially fatal condition whose prognosis depends on the promptness of management. Medical tourism, owing to heterogeneous practices and lack of postoperative follow-up, may lead to diagnostic and therapeutic delay, exposing patients to this type of complication. Even in cases of favourable outcome, functional and aesthetic sequelae can be significant.