Lower Extremity Salvage with Thoracodorsal Artery Perforator Free Flap in Condition of Symmetrical Peripheral Gangrene
| Autor: | Youn Hwan Kim, Soo Yeon Lim, Dong Woo Jang, Sang Wha Kim, Gyeong Hoe Kim, Il Hoon Sung, Jung Soo Yoon |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Soft Tissue Injuries Article Subject medicine.medical_treatment Respiratory arrest lcsh:Medicine Free flap 030230 surgery Free Tissue Flaps Amputation Surgical General Biochemistry Genetics and Molecular Biology Gangrene 03 medical and health sciences 0302 clinical medicine Hypovolemia medicine.artery medicine Humans Aged Wound Healing Thoracodorsal artery General Immunology and Microbiology business.industry lcsh:R Soft tissue Arteries Skin Transplantation General Medicine Middle Aged Plastic Surgery Procedures medicine.disease Surgery Lower Extremity Amputation 030220 oncology & carcinogenesis Female medicine.symptom Complication business Perforator Flap Research Article |
| Zdroj: | BioMed Research International BioMed Research International, Vol 2018 (2018) |
| ISSN: | 2314-6141 2314-6133 |
| DOI: | 10.1155/2018/6508607 |
| Popis: | Symmetrical peripheral gangrene (SPG) is rare but devastating complication which is characterized by symmetrical ischemic change of the distal extremities. In this report, we describe our management protocol for SPG, focusing on surgical approaches. Between January 2007 and February 2016, 10 thoracodorsal artery perforator (TDAP) free flaps were performed in 6 patients with SPG. Three patients were male and mean age was 56 (range, 44–69) years. All the patients were in shock. The causes of shock were sepsis in 4 cases, respiratory arrest in 1 case, and hypovolemia in 1 case. Eight transmetatarsal amputations and 2 Lisfranc amputations were performed. Flap sizes ranged from 7 × 11 cm to 25 × 15 cm. There were 3 cases of partial necrosis of the flap: two healed conservatively with dressings and one required skin graft. Three of the patients were later able to walk independently at Functional Ambulation Classification (FAC) level 6, one patient could walk independently on level surfaces at FAC level 5, and 2 could walk independently using walking aids, classified at FAC level 4. The average follow-up period was 18 (range, 6–54) months. In patients with SPG, minimal bone amputation and foot salvage with TDAP flaps were successful. Separate reconstruction of bone and soft tissue had good outcomes. |
| Databáze: | OpenAIRE |
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