L'anémie falciforme et la malaria à plasmodium falciparum: une menace pour la survie des lambeaux
Autor: | Mariethoz, Sophie, Pittet Cuenod, Brigitte Maud, Loutan, Louis, Humbert, James Ronald, Montandon, Denys |
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Jazyk: | francouzština |
Rok vydání: | 1998 |
Předmět: |
Hydroxyurea/therapeutic use
ddc:617 Research Malaria Falciparum/blood/complications Pentoxifylline/therapeutic use Surgical Flaps Risk Factors Leg Ulcer/etiology parasitic diseases Anemia Sickle Cell/blood/complications/drug therapy Vasodilator Agents/therapeutic use Antisickling Agents/therapeutic use Humans Postoperative Complications/etiology Child |
Zdroj: | Médecine & Hygiène, Vol. 56 (1998) pp. 2432-5 Annales de chirurgie plastique esthétique, Vol. 44, No 1 (1999) pp. 81-8 |
ISSN: | 0025-6749 0294-1260 |
Popis: | Plasmodium falciparum malaria, a parasitic disease, and sickle cell anemia, a hereditary disease, are two diseases affecting erythrocyte cycle, occurring with a high prevalence in tropical Africa. They may induce microthrombosis inducing vaso-occlusion, organ dysfunction and flap necrosis. During the acute phase of Plasmodium falciparum malaria, destruction of parasitized and healthy erythrocytes, release of parasite and erythrocyte material into the circulation, and secondary host reaction occur. Plasmodium falciparum infected erythrocytes also sequester in the microcirculation of vital organs and may interfere with microcirculatory flow in the flap during the postoperative period. The lower legs of homozygous sickle cell anemia patients are areas of marginal vascularity where minor abrasions become foci of inflammation. Inflammation results in decreased local oxygen tension, sickling of erythrocytes, increased blood viscosity and thrombosis with consequent ischemia, tissue breakdown and leg ulcer. Tissue transfer has become the procedure of choice for reconstruction of the lower third of the leg although flaps may become necrotic. The aim of this study is to analyse circumstances predisposing to surgical complications and to define preventive and therapeutic measures. A review of the literature will describe the current research and the new perspectives to treat sickle cell anemia, for example hydroxyurea and vasoactive substances (pentoxifylline, naftidrofuryl, buflomedil). |
Databáze: | OpenAIRE |
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