Case Report: Negative pressure wound therapy with instillation and dwell time as adjuvant therapy for limb salvage in a complicated necrotizing fasciitis on ischemic diabetic foot

This case demonstrates that a carefully staged multimodal adjuvant therapy protocol, incorporating negative pressure wound therapy with instillation and dwell time, dermal substitute application with negative pressure wound therapy, and multidisciplinary management of comorbidities, can serve as an effective limb salvage strategy in high-risk patients with diabetic foot ulcer-associated necrotizing fasciitis and extensive soft tissue defects when conventional reconstructive options are not feasible. This multimodal protocol may inform practice in high-risk or resource-limited settings.