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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...

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Autores principales: Hidaka, Takeaki, Kurita, Masakazu, Miyamoto, Shimpei, Watanabe, Mika, Kitamura, Yutaro, Okada, Keita, Fujiwara, Sayaka, Okazaki, Mutsumi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7489680/
https://www.ncbi.nlm.nih.gov/pubmed/32983814
http://dx.doi.org/10.1097/GOX.0000000000003074
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author Hidaka, Takeaki
Kurita, Masakazu
Miyamoto, Shimpei
Watanabe, Mika
Kitamura, Yutaro
Okada, Keita
Fujiwara, Sayaka
Okazaki, Mutsumi
author_facet Hidaka, Takeaki
Kurita, Masakazu
Miyamoto, Shimpei
Watanabe, Mika
Kitamura, Yutaro
Okada, Keita
Fujiwara, Sayaka
Okazaki, Mutsumi
author_sort Hidaka, Takeaki
collection PubMed
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.
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spelling pubmed-74896802020-09-24 Reconstruction for Severe Extracorporeal Membrane Oxygenation-induced Ischemic Lower Limb Injury Complicated by Osteomyelitis Hidaka, Takeaki Kurita, Masakazu Miyamoto, Shimpei Watanabe, Mika Kitamura, Yutaro Okada, Keita Fujiwara, Sayaka Okazaki, Mutsumi Plast Reconstr Surg Glob Open Reconstructive 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. Lippincott Williams & Wilkins 2020-08-25 /pmc/articles/PMC7489680/ /pubmed/32983814 http://dx.doi.org/10.1097/GOX.0000000000003074 Text en Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Reconstructive
Hidaka, Takeaki
Kurita, Masakazu
Miyamoto, Shimpei
Watanabe, Mika
Kitamura, Yutaro
Okada, Keita
Fujiwara, Sayaka
Okazaki, Mutsumi
Reconstruction for Severe Extracorporeal Membrane Oxygenation-induced Ischemic Lower Limb Injury Complicated by Osteomyelitis
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
topic Reconstructive
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7489680/
https://www.ncbi.nlm.nih.gov/pubmed/32983814
http://dx.doi.org/10.1097/GOX.0000000000003074
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