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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...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2020
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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. |
format | Online Article Text |
id | pubmed-7489680 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
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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