Free-flap Treatment of Congenital Pressure Necrosis of the Forearm in the Neonate
Abstract Background Microvascular surgery is not commonly performed in pediatric or neonatal populations, and when it is performed, it is done with some trepidation due to small size of the vessels, prolonged anesthesia, vasospasm, and difficult postoperative care. We describe microsurg...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2016-05-01
|
| Series: | Journal of Reconstructive Microsurgery Open |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0036-1584223 |
| _version_ | 1818969663831277568 |
|---|---|
| author | Ji Son Daniel A. Medalie |
| author_facet | Ji Son Daniel A. Medalie |
| author_sort | Ji Son |
| collection | DOAJ |
| description | Abstract
Background Microvascular surgery is not commonly performed in pediatric or neonatal populations, and when it is performed, it is done with some trepidation due to small size of the vessels, prolonged anesthesia, vasospasm, and difficult postoperative care. We describe microsurgical reconstruction of full-thickness loss of the forearm tissue in a 2-week-old due to congenital necrosis.
Methods A male infant was born with blistering of the ulnar aspect of the forearm. Removal of necrotic tissue resulted in a defect of 60% of his forearm skin and musculature with exposed ulna, ulnar nerve, and artery. Soft tissue defect was reconstructed using rectus free flap and split-thickness skin graft from the buttock.
Results The flap and graft survived without complication and the patient demonstrated a completely healed wound.
Conclusion With advances in operative microscopes, instruments, surgical techniques, and anesthetic techniques, free tissue transfer in the neonate is feasible despite small vascular caliber. An experienced surgical team remains one of the most important factors to obtain a good outcome. |
| first_indexed | 2024-12-20T14:24:10Z |
| format | Article |
| id | doaj.art-2b3111218ffc4704af04f478d13f4513 |
| institution | Directory Open Access Journal |
| issn | 2377-0813 2377-0821 |
| language | English |
| last_indexed | 2024-12-20T14:24:10Z |
| publishDate | 2016-05-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Journal of Reconstructive Microsurgery Open |
| spelling | doaj.art-2b3111218ffc4704af04f478d13f45132022-12-21T19:37:51ZengGeorg Thieme Verlag KGJournal of Reconstructive Microsurgery Open2377-08132377-08212016-05-01010102903110.1055/s-0036-1584223Free-flap Treatment of Congenital Pressure Necrosis of the Forearm in the NeonateJi Son0Daniel A. Medalie1Division of Plastic and Reconstructive Surgery, The MetroHealth System, Cleveland, OhioDivision of Plastic and Reconstructive Surgery, The MetroHealth System, Cleveland, OhioAbstract Background Microvascular surgery is not commonly performed in pediatric or neonatal populations, and when it is performed, it is done with some trepidation due to small size of the vessels, prolonged anesthesia, vasospasm, and difficult postoperative care. We describe microsurgical reconstruction of full-thickness loss of the forearm tissue in a 2-week-old due to congenital necrosis. Methods A male infant was born with blistering of the ulnar aspect of the forearm. Removal of necrotic tissue resulted in a defect of 60% of his forearm skin and musculature with exposed ulna, ulnar nerve, and artery. Soft tissue defect was reconstructed using rectus free flap and split-thickness skin graft from the buttock. Results The flap and graft survived without complication and the patient demonstrated a completely healed wound. Conclusion With advances in operative microscopes, instruments, surgical techniques, and anesthetic techniques, free tissue transfer in the neonate is feasible despite small vascular caliber. An experienced surgical team remains one of the most important factors to obtain a good outcome.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0036-1584223microsurgeryneonatal microvascular reconstructioncongenital pressure necrosis |
| spellingShingle | Ji Son Daniel A. Medalie Free-flap Treatment of Congenital Pressure Necrosis of the Forearm in the Neonate Journal of Reconstructive Microsurgery Open microsurgery neonatal microvascular reconstruction congenital pressure necrosis |
| title | Free-flap Treatment of Congenital Pressure Necrosis of the Forearm in the Neonate |
| title_full | Free-flap Treatment of Congenital Pressure Necrosis of the Forearm in the Neonate |
| title_fullStr | Free-flap Treatment of Congenital Pressure Necrosis of the Forearm in the Neonate |
| title_full_unstemmed | Free-flap Treatment of Congenital Pressure Necrosis of the Forearm in the Neonate |
| title_short | Free-flap Treatment of Congenital Pressure Necrosis of the Forearm in the Neonate |
| title_sort | free flap treatment of congenital pressure necrosis of the forearm in the neonate |
| topic | microsurgery neonatal microvascular reconstruction congenital pressure necrosis |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0036-1584223 |
| work_keys_str_mv | AT jison freeflaptreatmentofcongenitalpressurenecrosisoftheforearmintheneonate AT danielamedalie freeflaptreatmentofcongenitalpressurenecrosisoftheforearmintheneonate |