Late Eyelid Reconstruction of Necrotizing Fasciitis

Necrotizing fasciitis (NF) is a devastating severe infection. NF involving periorbital tissue is rarely found. We reported a 42-year-old woman with eyelid edema surrounded by necrotic tissue and pus production for about a week. LRINEC score was 6. Widespread local excision and debridement were urgently performed. Reconstruction performed two weeks after the onset. The rotational flap is taken from her forehead to prompt good skin remodeling and vascularization. A part of the flap slipped underneath the temporal skin. The flap was perfectly grown, and the eyelid function recovered. NF is a rare severe infection and rarely involves the periorbital area. Early recognition is critical. LRINEC score could be used, and urgent debridement is needed. Late skin flap could be a choice to cover the debrided skin and give a good aesthetic yet functional eyelid.