Use of barbatimão (STRYPHNODENDRON ADSTRINGENS) in the treatment of odontogenic cervical necrotizing fasciitis: A case report

Necrotizing fasciitis is an uncommon infection that causes severe destruction of soft tissues, which can lead to death if aggressive treatment is not adopted. A case of Necrotizing Fasciitis of odontogenic origin will be narrated in a patient with Down Syndrome, victim of a mandible fracture. On admission, the patient underwent imaging and laboratory tests (CT) and, afterwards, underwent general anesthesia for multiple extractions and fracture osteosynthesis.The patient presented, in the postoperative period, osteomyelitis with extraoral tissue necrosis, which evolved to Necrotizing Fasciitis and required a re-approach to remove necrotic bone tissue with the installation of a 2.4 plaque through the extraoral route. Because of the formation of a necrosis area, treatment with antibiotics and dressing with Barbatimão ointment was chosen, with a good evolution of the condition, with satisfactory healing.In the fourth postoperative month there was formation of granulation tissue and intraoral bone exposure that was treated with debridement and suture, in addition to removal of devitalized bone tissue and a screw located in the region, leading to remission of the condition and return to normal state.