One-stage double free flap arteriovenous loop reconstruction of a massive abdominothoracic defect following necrotizing fasciitis

• Verfasst von: Falkner, Florian [VerfasserIn]
• Verfasst von: Thomas, Benjamin [VerfasserIn]
• Verfasst von: Hundeshagen, Gabriel [VerfasserIn]
• Verfasst von: Wittenberg-Rump, Gerhard [VerfasserIn]
• Verfasst von: Bliesener, Björn [VerfasserIn]
• Verfasst von: Bigdeli, Amir Khosrow [VerfasserIn]
• Verfasst von: Kneser, Ulrich [VerfasserIn]
• Titel: One-stage double free flap arteriovenous loop reconstruction of a massive abdominothoracic defect following necrotizing fasciitis
• Titelzusatz: a case report
• Verf.angabe: Florian Falkner MD, Benjamin Thomas MD, Gabriel Hundeshagen MD, MMS, Gerhard Wittenberg MD, Björn Bliesener MD, Amir K. Bigdeli MD, Ulrich Kneser MD
• E-Jahr: 2020
• Jahr: 21 October 2020
• Umfang: 5 S.
• Fussnoten: Gesehen am 17.08.2021
• Titel Quelle: Enthalten in: Microsurgery
• Ort Quelle: New York, NY [u.a.] : Wiley-Liss, 1979
• Jahr Quelle: 2020
• Band/Heft Quelle: 40(2020), 8, Seite 911-915
• ISSN Quelle: 1098-2752
• DOI: doi:10.1002/micr.30673
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1767148968
• K10plus-PPN:
  Universitätsbibliothek
• Lokale URL UB: Zum Volltext

Abstract

We report the case of a 67-year old male with necrotizing fasciitis after injection of the glenohumeral joint. After extensive debridement a massive defect from the left hip joint to the left upper arm, exposing ribs, scapula, axillary vessels and brachial plexus (45 × 40 cm) was present. Reconstruction was performed with a conjoined right myocutaneous tensor fasciae lata/vastus lateralis flap and a left myocutaneous vastus lateralis flap in combination with an arteriovenous loop originating from the axillary vessels using the greater saphenous vein. Revisional surgeries were necessary including ribs resection and flap re-advancements. Due to multiorganic failure invasive ventilation, renal replacement- and extensive transfusion therapy was required. After 241 days the patient was discharged for rehabilitation. At the 12 months follow-up wounds were sufficiently closed without the need for further intervention. This case illustrates that immediate diagnosis followed by an aggressive multidisciplinary treatment approach is crucial for the patient survival.