Necrotizing fasciitis is treated by incisional drainage or immediate debridement. Generally, an infected wound should not be sutured or closured, but should be allowed to secondarily heal as an open wound. Treatment of necrotizing fasciitis involving the neck or submandibular region requires careful attention to major blood vessels or nerves. We therefore could not perform debridement radically. The wound should be continuously irrigated or applied ointment, but the presence of a fistula

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... es leads to prolonged wound healing. We describe our experience with an uncontrollable fistula attributed to debridement of submandibular necrotizing fasciitis, although irrigation had been continued for 6 weeks. After performing Negative Pressure Wound Therapy, with a V.A.C. ® ATS system good granulation tissue proliferated in 3 days, and the fistula disappeared. The wound completely healed in 1 week. Furthermore, the clinical course has been good, with no recurrence of a fistula after 3 months. We report a case of early healing of an uncontrollable fistula treated by a V.A.C. ® ATS system. : submandibular necrotizing fasciitis (顎下部壊死性筋膜炎) ,debridement (壊死組織除去) ,V.A.C. system (V.A.C. システム) ,Negative Pressure Wound Therapy (陰圧閉鎖療法) ,uncontrollable fistula (難治性瘻孔) 1) 神戸大学大学院医学研究科外科系講座口腔外科学分野 (主任:古森孝英教授) 2) 神戸大学大学院医学研究科外科系講座形成外科学分野 (主任:寺師浩人教授) 1)