Constriction band-induced vascular compromise of the foot: classification and management of the "intermediate" stage of constriction-ring syndrome.
Gangrene of an extremity secondary to a congenital constriction band may result from in utero or postnatal vascular compromise. Often ths process is completed in utero following spontaneous resolution of the vascular insufficiency, resulting in a healed wound by fetal repair and regeneration or in amputation of the distal part. When this process is progressive as a result of worsening lymphaticovenous and/or arterial obstruction with associated soft-tissue necrosis, salvage of the distal part can be accomplished by immediate decompression to evacuate the lymphedema fluid, staged band excision, Z-plasty closure, and topical antimicrobial therapy of the open wound. A revised classification of constriction-ring syndrome incorporating the "intermediate" stage (3B) of severe lymphaticovenous compromise with soft-tissue loss is introduced.
Weinzweig
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Division of Plastic Surgery, University of Illinois at Chicago, USA.
D000328:Adult; D000652:Amniotic Band Syndrome / Q000145:classification / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005260:Female; D005528:Foot / Q000098:blood supply* / Q000473:pathology; D005532:Foot Deformities, Congenital / Q000209:etiology / Q000473:pathology; D005734:Gangrene / Q000209:etiology / Q000473:pathology; D006801:Humans; D007231:Infant, Newborn; D008297:Male