Necrotizing fasciitis after neonatal circumcision

A 6-day-old infant had extensive necrotizing fasciitis involving most of the abdominal wall develop after circumcision with a Plastibell device (Hollister, Inc). He survived this life-threatening infection after vigorous cardiovascular support, antibiotic therapy, and aggressive surgical debridement. The diagnosis, bacteriology, and management of necrotizing fasciitis are briefly discussed. The technical aspects and complications of Gomco (Gomco Surgical Manufacturing Corp) and Plastibell circumcision are compared. Strangulation and devitalization of the prepuce is invariably associated with Plastibell circumcision, and it may render neonates circumcised by this technique more susceptible to serious wound infection.