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diabetes, PVD, immune compromised, and recent surgery. Type II necrotizing fasciitis is generally monomicrobial. It is caused by group A Streptococcus or other beta-hemolytic streptococci that is either alone or in combination with other pathogens, most commonly S. aureus. Patient’s culture came back with growth of Staphlococcus aureus. (Stevens, 2016) The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System, WIfI, is a system for classifying the severity of limb threat that is intended to reflect clinical considerations that impact management and amputation risk. WIfI is an acronym for wound, ischemia, and foot infection. Each category has a different grade. For wound, a grade 0 is rest pain; no wound; no ulcer; no gangrene. Grade 1 is a small shallow ulcer(s) on distal leg or foot, any exposed bone is only limited to distal phalanx(ie. Minor tissue loss, limb salvageable with possible simple digital amputation or skin coverage). Grade 2 involves a deeper ulcer on distal leg or foot with exposed bone, joint, or tendon, or shallow heel ulcer without involvement of the calcaneus( ie. Major tissue loss: salvageable with >3 digital amputations or standard transmetatarsal amputation plus skin coverage). Grade 3 is an extensive deep ulcer of the forefoot and/or midfoot, or full thickness heel ulcer with or without involvement of the calcaneus(ie. Extensive tissue loss: salvageable only with complex foot reconstruction or nontraditional TMA). Patient is a grade 2 for wound because he had a deep ulcer. Ischemia also has grades 0-3. Grade 0 is ABI (ankle-brachial index) > 0.8, with ankle systolic pressure >100mmHg, toe pressure(TP) >60. Grade 1 is ABI 0.6-0.79, ankle systolic pressure 70-100mmHg, TP 40-59. Grade 2 is ABI 0.4-0.59, ankle systolic pressure 50-70mmHg, TP 30-39. Grade 3 is ABI <0.39, ankle systolic pressure <50mmHg, TP <30. The third category is foot infection. Grade 0 is no symptoms or signs of infection. Grad
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