Abstract:Objective To investigate the early diagnostic methods， treatment strategies， and clinical efficacy of debridement combined with vacuum sealing drainage（VSD） in abdominal wall necrotizing fasciitis. Methods An analysis was conducted on clinicopathological data from patients with postoperative abdominal wall necrotizing fasciitis treated at the Second Affiliated Hospital of Nanjing Medical University between June 2023 and May 2025. Upon diagnosis， patients immediately underwent debridement combined with VSD therapy. Data on the number of debridement，VSD applications，and wound healing time were recorded. Results Two male patients（aged 65 and 79 years， respectively） with comorbid diabetes mellitus were enrolled. Both patients underwent two sessions of debridement combined with VSD， with postoperative healing times of 31 days and 24 days， respectively. No complications were reported during the 6-month follow-up. Conclusion Necrotizing fasciitis of the abdominal wall has a low incidence rate. It has an insidious onset but progresses rapidly and is a serious condition. Immediate surgical debridement and drainage are critical upon diagnosis. VSD is a safe and effective adjunctive therapy in the treatment of abdominal wall necrotizing fasciitis，reducing mortality and improving prognosis.