PMID: 11917951Mar 29, 2002Paper

Sequential microsurgical flap reconstruction following purpura fulminans during infancy and childhood

Journal of Reconstructive Microsurgery
A JesterB Bickert

Abstract

Purpura fulminans is a potentially lethal complication of meningococcal septicemia, characterized by progressive hemorrhagic skin lesions, which can result in extensive necrosis and mummification of all the extremities. With improving survival rates in infancy and childhood, plastic surgeons are challenged more often to provide sufficient and stable soft-tissue coverage. Usually, conservative methods, such as skin grafting or amputation, are favored by many pediatric surgeons, since further specialized departments and training are not required. Often secondary reconstructive procedures to improve soft-tissue coverage have to be performed to achieve proper prosthetic fitting. Microsurgical techniques are used only in selected cases, after failure of other procedures for defect coverage. In two cases of post-acute purpura fulminans, two free flaps and three microsurgically dissected flaps were used as primary measures for defect coverage and preservation of stump length. Despite the presence of vasculitis, all flaps survived. In a third case, secondary reconstructive measures had to be performed 1 year after purpura fulminans due to insufficient soft-tissue coverage after lower leg amputation. This patient also had contractures o...Continue Reading

Citations

Jul 29, 2009·Journal of Pediatric Surgery·Willy D BoeckxEric Van den Kerckhove
Oct 24, 2007·Annales de chirurgie plastique et esthétique·A-L BouffautF Duteille
Aug 26, 2006·Plastic and Reconstructive Surgery·Franck DuteilleMichel Pannier
Jul 1, 2005·Plastic and Reconstructive Surgery·Koenraad Van LanduytStanislas Monstrey

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