Department of Plastic and Reconstructive Surgery, Hirosaki University School of Medicine, 52 Hontyou, Hirosaki, Aomori 036-8563, Japan.
J Plast Reconstr Aesthet Surg. 2012 Feb;65(2):252-5. doi: 10.1016/j.bjps.2011.07.004. Epub 2011 Jul 26.
Purpura fulminans (PF) is a rare syndrome of intravascular thrombosis and haemorrhagic infarction of the skin. The initial symptom of PF is peripheral purpura which progresses to necrosis very rapidly. The prognosis of PF is poor, and the mortality is reported to be around 40%. Even if the patient survives, the patient may require amputation or reconstruction for limbs and facial necrosis.
A 48-year-old male suffered from PF following a left cerebellopontine angle tumour excision. His nose and upper lip fell into necrosis afterwards. We performed nose and upper lip reconstruction at 8 months after the onset. We used a forehead flap for the nasal reconstruction and a free forearm flap for the lining. His upper lip was reconstructed with bilateral nasolabial orbicularis oris myocutaneous flaps.
The colour and texture match of the reconstructed nose and lip is good. He could open his mouth wide enough and close completely.
Facial reconstruction after PF is very difficult, because the patient has extensive scarring around the defect and there is little intact facial tissue. However, we performed a facial reconstruction using local flaps as much as possible, and obtained good results.
暴发性紫癜（PF）是一种罕见的皮肤血管内血栓形成和出血性梗死综合征。PF 的初始症状是周围紫癜，很快进展为坏死。PF 的预后很差，死亡率约为 40%。即使患者存活，肢体和面部坏死也可能需要截肢或重建。
一名 48 岁男性在左桥小脑角肿瘤切除术后出现 PF，随后鼻子和上唇坏死。我们在发病后 8 个月进行了鼻子和上唇重建。我们使用额部皮瓣进行鼻重建，使用游离前臂皮瓣进行衬里。他的上唇用双侧鼻唇沟颊肌瓣重建。
重建的鼻子和嘴唇的颜色和质地匹配良好。他可以足够宽地张开嘴并完全闭上。
PF 后的面部重建非常困难，因为患者缺损周围有广泛的瘢痕，并且面部没有多少完整的组织。然而，我们尽可能使用局部皮瓣进行面部重建，取得了良好的效果。
