Tissue necrosis after use of enoxaparin in total knee arthroplasty: a case report.

Tissue necrosis at the injection site of enoxaparin is a rare adverse effect. Most of the reported clinical course of this necrosis is uneventful. Here we review a case of tissue necrosis that developed after use of enoxaparin and required debridement followed by reconstructive surgery. Until now, such a case has not been reported in the English-language literature. As enoxaparin is being used more often for prevention of deep vein thrombosis in patients who undergo arthroplasty surgery, awareness and recognition of this adverse event and careful supervision of all patients who receive this medication are essential.