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Free tissue transfer in patients with systemic lupus erythematosus
A Raurell1, O M Austin, V Ramakrishnan
1Department of Plastic and Reconstructive Surgery, Kingston General Hospital, Hull, UK.
British Journal of Plastic Surgery
|February 5, 2000
Summary
Systemic lupus erythematosus (SLE) can cause severe skin necrosis requiring complex reconstruction. A free latissimus dorsi flap successfully reconstructed soft tissue loss in a cellist's dominant hand.
Area of Science:
- Rheumatology
- Plastic Surgery
- Autoimmune Diseases
Background:
- Systemic lupus erythematosus (SLE) is an autoimmune disease causing vasculitis and potential skin necrosis.
- Extensive skin and soft tissue loss in SLE patients presents reconstructive challenges, especially with generalized vasculitis.
- Surgical reconstruction options include local flaps and microvascular free tissue transfer.
Observation:
- A professional cellist experienced significant soft tissue loss in her dominant hand due to SLE.
- The patient's condition involved generalized vasculitis, complicating potential surgical interventions.
- The affected area required extensive excision and reconstruction.
Findings:
- Successful reconstruction was achieved using a free latissimus dorsi muscle flap.
- Perioperative anticoagulation and corticosteroid treatment were administered.
- The flap provided coverage for the extensive soft tissue defect in the dominant hand.
Implications:
- This case demonstrates the feasibility of free flap reconstruction in SLE patients with vasculitis.
- Management with anticoagulation and corticosteroids is crucial for successful outcomes in these patients.
- The successful reconstruction allowed the cellist to potentially return to her profession.