Sapino Gianluca, Deglise Sebastien, Raffoul Wassim, di Summa Pietro G
Department of Plastic, Reconstructive and Hand Surgery, University Hospital of Lausanne (CHUV), University of Lausanne, Lausanne, Switzerland.
Department of Vascular Surgery, University Hospital of Lausanne (CHUV), University of Lausanne, Lausanne, Switzerland.
Arch Plast Surg. 2021 Sep;48(5):543-546. doi: 10.5999/aps.2020.02397. Epub 2021 Sep 15.
Despite the extensive use of lithotomy position in several plastic surgery procedures, most reports regarding the related incidence of complications are presented in the urologic, gynecologic, and anesthesiologic fields. We present the case of a 54-year-old male patient. polytrauma patient who underwent internal iliac artery embolization leading to extensive gluteal necrosis requiring: debridement, abdominoperineal resection and composite anterolateral thigh flap reconstruction with prolonged lithotomy position. The patient presented lower limb ischemia briefly after surgical theater. A computed tomography scan revealed the obstruction of the left superficial femoral artery requiring emergency revascularization. Arterial thrombosis is a potentially devastating complication and plastic surgeons should be aware of the possible dangers when performing surgeries in prolonged lithotomy position. Preoperative detection of patients at high risks for developing complications should be performed in order to implement preventive measures and avoid potentially life-threatening sequelae.
尽管截石位在多种整形手术中被广泛使用，但大多数关于相关并发症发生率的报告都出现在泌尿外科、妇科和麻醉学领域。我们报告一例54岁男性多发伤患者的病例，该患者接受了髂内动脉栓塞术，导致广泛的臀肌坏死，需要进行清创、腹会阴切除术以及采用延长截石位的股前外侧复合皮瓣重建术。患者在手术室短暂出现下肢缺血。计算机断层扫描显示左股浅动脉阻塞，需要紧急血管重建。动脉血栓形成是一种潜在的毁灭性并发症，整形外科医生在进行延长截石位手术时应意识到可能的危险。应在术前对有发生并发症高风险的患者进行检测，以便采取预防措施并避免潜在的危及生命的后遗症。
