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We present the case of a 48-year-old male who developed tissue necrosis and subsequent necrotizing fasciitis in his right upper extremity after sustaining a puncture injury from a large black locust tree (Robinia pseudoacacia) splinter. Blood and intraoperative wound cultures revealed Streptococcus constellatus and Eikenella corrodens infection. The treatment consisted of IV antibiotics, fasciotomy, and multiple debridements, which left a 30 x 5-cm defect, requiring negative pressure wound therapy with Integra Dermal Regeneration Template
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