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COVID-19 阳性年轻男性四肢重建术后前外侧大腿皮瓣部分坏死的罕见病例。

Unusual case of a free anterolateral thigh flap partial necrosis in a COVID-19 positive young male following extremity reconstruction.

机构信息

Department of Burn & Plastic Surgery, All India Institute of Medical Sciences, Kalyani, West Bengal, 741245, India.

Department of Plastic Surgery, South Eastern Railway Central Hospital, Kolkata, West Bengal, 700043, India.

出版信息

Chin J Traumatol. 2023 Sep;26(5):308-310. doi: 10.1016/j.cjtee.2023.02.002. Epub 2023 Feb 21.

DOI:10.1016/j.cjtee.2023.02.002
PMID:36858870
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9942487/
Abstract

Free flap procedure provides an overall success rate of 97%, which decreases to 85% in hypercoagulable states. COVID-19, as a pro-thrombotic disorder, therefore seems detrimental to free flap survival. We encountered a case of unique pattern of free flap partial failure in a young male who underwent extremity reconstruction. The patient was diagnosed as COVID-19 positive on the 3rd day post-reconstruction. The flap survived well for the first 7 days post-operatively, but gradually the skin got necrosed and the subcutaneous fat layer was preserved when debriding. To our knowledge, this is the only case in which the skin of the free flap of a COVID-19 positive patient was necrosed almost entirely subsequently, while the subcutaneous fat was relatively preserved.

摘要

游离皮瓣手术的总体成功率为 97%，而在高凝状态下，成功率降至 85%。COVID-19 是一种促血栓形成的疾病，因此似乎对游离皮瓣的存活不利。我们遇到了一个年轻男性四肢重建后游离皮瓣部分失败的特殊病例。该患者在重建后第 3 天被诊断为 COVID-19 阳性。皮瓣在术后 7 天内恢复良好，但逐渐出现皮肤坏死，清创时保留了皮下脂肪层。据我们所知，这是首例 COVID-19 阳性患者的游离皮瓣皮肤几乎完全坏死，而皮下脂肪相对保留的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8433/10533533/6d8887d51dcb/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8433/10533533/d1f68a331b88/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8433/10533533/1f70e6a92d8d/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8433/10533533/b0ed740058a3/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8433/10533533/67edec35e78b/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8433/10533533/7489163c9920/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8433/10533533/6578c1d0accf/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8433/10533533/6d8887d51dcb/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8433/10533533/d1f68a331b88/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8433/10533533/1f70e6a92d8d/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8433/10533533/b0ed740058a3/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8433/10533533/67edec35e78b/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8433/10533533/7489163c9920/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8433/10533533/6578c1d0accf/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8433/10533533/6d8887d51dcb/gr7.jpg

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