Reconstruction for Severe Extracorporeal Membrane Oxygenation-induced Ischemic Lower Limb Injury Complicated by Osteomyelitis
Summary: Extracorporeal membrane oxygenation (ECMO) is a well-established mechanical circulatory support system used in patients with life-threatening cardiopulmonary conditions. However, severe complications associated with vascular access require consideration. We report a patient with fatal ventr...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2020-08-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003074 |
| _version_ | 1818027103619121152 |
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| author | Takeaki Hidaka, MD Masakazu Kurita, MD, PhD Shimpei Miyamoto, MD, PhD Mika Watanabe, MD Yutaro Kitamura, MD Keita Okada, MD, PhD Sayaka Fujiwara, MD, PhD Mutsumi Okazaki, MD, PhD |
| author_facet | Takeaki Hidaka, MD Masakazu Kurita, MD, PhD Shimpei Miyamoto, MD, PhD Mika Watanabe, MD Yutaro Kitamura, MD Keita Okada, MD, PhD Sayaka Fujiwara, MD, PhD Mutsumi Okazaki, MD, PhD |
| author_sort | Takeaki Hidaka, MD |
| collection | DOAJ |
| description | Summary: Extracorporeal membrane oxygenation (ECMO) is a well-established mechanical circulatory support system used in patients with life-threatening cardiopulmonary conditions. However, severe complications associated with vascular access require consideration. We report a patient with fatal ventricular arrhythmia who was successfully resuscitated with ECMO but who developed severe lower limb ischemia, which resulted in compartment syndrome. Even with emergent fasciotomy, tissue necrosis developed in wide areas of the limb, with subsequent tibial osteomyelitis. After extensive debridement and tibial sequestrectomy, the soft tissue and bone defect were simultaneously reconstructed with free tissue transfer of the latissimus dorsi muscle and scapular tip composite flap. The limb was successfully salvaged with satisfactory functional outcomes without major complications. This report discusses limb reconstruction for ECMO-induced compartment syndrome and illustrates the importance of appropriate selection of reconstruction methods among various composite flaps. |
| first_indexed | 2024-12-10T04:42:35Z |
| format | Article |
| id | doaj.art-f7f11f6028e04ad08d7e59c6e94e526d |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-12-10T04:42:35Z |
| publishDate | 2020-08-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-f7f11f6028e04ad08d7e59c6e94e526d2022-12-22T02:01:51ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742020-08-0188e307410.1097/GOX.0000000000003074202008000-00051Reconstruction for Severe Extracorporeal Membrane Oxygenation-induced Ischemic Lower Limb Injury Complicated by OsteomyelitisTakeaki Hidaka, MD0Masakazu Kurita, MD, PhD1Shimpei Miyamoto, MD, PhD2Mika Watanabe, MD3Yutaro Kitamura, MD4Keita Okada, MD, PhD5Sayaka Fujiwara, MD, PhD6Mutsumi Okazaki, MD, PhD7From the * Department of Plastic, Reconstructive and Aesthetic Surgery, The University of Tokyo Hospital, Tokyo, JapanFrom the * Department of Plastic, Reconstructive and Aesthetic Surgery, The University of Tokyo Hospital, Tokyo, JapanFrom the * Department of Plastic, Reconstructive and Aesthetic Surgery, The University of Tokyo Hospital, Tokyo, JapanFrom the * Department of Plastic, Reconstructive and Aesthetic Surgery, The University of Tokyo Hospital, Tokyo, JapanFrom the * Department of Plastic, Reconstructive and Aesthetic Surgery, The University of Tokyo Hospital, Tokyo, Japan† Department of Orthopaedic Surgery and Spinal Surgery, The University of Tokyo Hospital, Tokyo, Japan‡ Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan.From the * Department of Plastic, Reconstructive and Aesthetic Surgery, The University of Tokyo Hospital, Tokyo, JapanSummary: Extracorporeal membrane oxygenation (ECMO) is a well-established mechanical circulatory support system used in patients with life-threatening cardiopulmonary conditions. However, severe complications associated with vascular access require consideration. We report a patient with fatal ventricular arrhythmia who was successfully resuscitated with ECMO but who developed severe lower limb ischemia, which resulted in compartment syndrome. Even with emergent fasciotomy, tissue necrosis developed in wide areas of the limb, with subsequent tibial osteomyelitis. After extensive debridement and tibial sequestrectomy, the soft tissue and bone defect were simultaneously reconstructed with free tissue transfer of the latissimus dorsi muscle and scapular tip composite flap. The limb was successfully salvaged with satisfactory functional outcomes without major complications. This report discusses limb reconstruction for ECMO-induced compartment syndrome and illustrates the importance of appropriate selection of reconstruction methods among various composite flaps.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003074 |
| spellingShingle | Takeaki Hidaka, MD Masakazu Kurita, MD, PhD Shimpei Miyamoto, MD, PhD Mika Watanabe, MD Yutaro Kitamura, MD Keita Okada, MD, PhD Sayaka Fujiwara, MD, PhD Mutsumi Okazaki, MD, PhD Reconstruction for Severe Extracorporeal Membrane Oxygenation-induced Ischemic Lower Limb Injury Complicated by Osteomyelitis Plastic and Reconstructive Surgery, Global Open |
| title | Reconstruction for Severe Extracorporeal Membrane Oxygenation-induced Ischemic Lower Limb Injury Complicated by Osteomyelitis |
| title_full | Reconstruction for Severe Extracorporeal Membrane Oxygenation-induced Ischemic Lower Limb Injury Complicated by Osteomyelitis |
| title_fullStr | Reconstruction for Severe Extracorporeal Membrane Oxygenation-induced Ischemic Lower Limb Injury Complicated by Osteomyelitis |
| title_full_unstemmed | Reconstruction for Severe Extracorporeal Membrane Oxygenation-induced Ischemic Lower Limb Injury Complicated by Osteomyelitis |
| title_short | Reconstruction for Severe Extracorporeal Membrane Oxygenation-induced Ischemic Lower Limb Injury Complicated by Osteomyelitis |
| title_sort | reconstruction for severe extracorporeal membrane oxygenation induced ischemic lower limb injury complicated by osteomyelitis |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003074 |
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