case_images: PMC11803882_01
case_images: NSTI before debridement.
case_images: gr1.jpg
case_images: PMC11803882_01_gr1.jpg
case_images: f0005
case_images: He was transferred to the Department of Orthopaedics and diagnosed with NSTI (Fig. 1).
case_images: After debridement.
case_images: gr2.jpg
case_images: PMC11803882_01_gr2.jpg
case_images: f0010
case_images: Acute surgical debridement was performed with resection of soft tissue of the left hemithorax, abdomen, neck, and upper arm including the pectoral muscles, the left side of the latissimus dorsi, resulting in exposed costa and periosteum, vessels and nerves in the axilla in an area of roughly 20 x 20 centimetres (Fig. 2).
case_images: After reconstruction.
case_images: gr3.jpg
case_images: PMC11803882_01_gr3.jpg
case_images: f0015
case_images: The contralateral free partial latissimus dorsi (LD) flap was transferred to the left axilla for protection of the vessels and nerves and SSG was applied to the remaining defect (Fig. 3).
case_images: After application of NPWT.
case_images: gr4.jpg
case_images: PMC11803882_01_gr4.jpg
case_images: f0020
case_images: To facilitate fixation of the skin graft and free flap, continuous NPWT was applied directly on the free flap and its pedicle - as well as on the SSGs - with a pressure of 80 mmHg (Fig. 4).
case_images: Nine months postoperative.
case_images: gr5.jpg
case_images: PMC11803882_01_gr5.jpg
case_images: f0025
case_images: This increased to a range of motion of 100  in shoulder abduction nine months after resection (Fig. 5).