Free anterolateral thigh perforator flap in a patient with systemic sclerosis and Raynaud's phenomenon
Carcinoma, Squamous Cell
Reconstructive Surgical Procedures
In this report, we present the first successful case of a perforator flap microvascular tissue transfer in a patient with severe scleroderma and Raynaud's phenomenon. Microvascular transfer in the setting of Raynaud's phenomenon has been reported in four patients in the medical literature. In one case (radial forearm flap), the flap was lost on postoperative day 3 due to severe, unremitting vasospasm. Together, these findings provide putative evidence that microvascular tissue transfer of myocutaneous flaps and even perforator flaps is feasible in patients with severe scleroderma. It is likely, however, that flap complication rates may be higher. Every effort should be made to keep the patient warm and avoid vasospasm. Calcium channel blockers may be helpful, but their use should probably be avoided if hypotension is encountered. Similarly, anticoagulation may be helpful, although its use in this case was precluded by intracranial surgery. Copyright ©2006 by the American Society of Plastic Surgeons.
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