Salvage of the hand with a free flap in a hemodialysis patient with finger gangrene and ipsilateral arteriovenous fistula: a case report

Annals of Vascular Surgery
Ching-Hua HsiehSeng-Feng Jeng

Abstract

We describe the case of a female with end-stage renal disease who developed a left ischemic hand and index finger gangrene 2 years after commencement of hemodialysis. Ray amputation was performed, however, the surgical wound was complicated by progressive soft tissue necrosis and metacarpal bones exposure. To avoid amputation at a higher level, we repaired the defect successfully with a free anterolateral thigh perforator flap. A radiocephalic arteriovenous fistula, the dialysis access, was divided to provide the recipient vessels. Reconstruction with this method has the advantage of a staged arteriovenous fistula, which can increase the free-flap success rate, and has the potential to improve perfusion of the distal ischemic hand.

References

Apr 16, 1998·The Journal of Surgical Research·A H MorsyA B Lumsden
Apr 1, 2000·American Journal of Physical Medicine & Rehabilitation·J J NicholasS Jensik
Aug 10, 2001·Plastic and Reconstructive Surgery·B S AtiyehR S Musharafieh
Jan 19, 2002·American Journal of Nephrology·M P Levine

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Citations

Apr 10, 2007·Annals of Vascular Surgery·Ting-Lung LinChing-Hua Hsieh
Mar 30, 2007·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Sinclair M GoreJagdeep S Chana
Mar 27, 2015·Case Reports in Vascular Medicine·Shamir O CawichVijay Naraynsingh

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