Mucormycosis is a frightening medical condition which has baffled clinicians all over the world. Cutaneous
mucormycosis is, in particular, extremely invasive, leading to high rates of morbidity and mortality. Timely intervention with antifungal
drug Amphotericin B and early radical
debridement are keys for favorable outcome.Three consecutive patients died of cutaneous
mucormycosis despite being treated with
Amphotericin B and an early extensive
debridement. With disappointing results in these patients, the treatment protocol was changed. Instead of early aggressive surgical intervention, the
debridement was withheld for minimum 10 days or more, until
Amphotericin B started to show its effect.
Debridement was carried out conservatively after 10 days. The resultant raw area was covered with the split-thickness skin graft later.The concept of "Delay the
Debridement" was efficacious in the successive 5 patients with minimum morbidity and less reconstructive requirements. Our study contradicts the popular wisdom of the necessity of early vigorous
debridement. We think that the timing of
debridement is one of the most important determinants of mortality.The scientific reasons for delaying the
debridement have been discussed. This appears to be the first report of successful management of cutaneous
mucormycosis by delaying the
debridement.