Functional Reconstruction of the Hand After Gangrene Affecting All Extremities.
Zhixue Lim, Dilys Hoh, Sandeep J Sebastin
✦ AI-curated · Sources linked
Case in brief
A patient with symmetric peripheral gangrene (SPG) secondary to septic shock and prolonged vasopressor use presented with gangrene affecting all four extremities. The condition resulted in significant functional loss and limited reconstructive options. A staged reconstructive approach was employed for both hands, incorporating on-top plasties, ray amputation, and local flap rearrangement, ultimately restoring basic hand function.
What made this case unusual
The case highlights the challenges of reconstructive surgery in a patient with SPG affecting all extremities, where standard options like toe transfers were not viable.
Diagnostic / clinical pearl
Clinicians should consider the implications of prolonged vasopressor use in patients with septic shock, as it may lead to symmetric peripheral gangrene and complicate reconstructive options.
Why it matters
Understanding the reconstructive challenges in SPG can guide surgical planning and improve outcomes in similar cases, emphasizing the need for tailored approaches in complex scenarios.