title: Salvaging limbs in cases of severe purpura fulminans: advantages of free flaps.
abstract: BACKGROUND
  Purpura fulminans remains a severe and potentially life-threatening disorder, despite advances in intensive care that have led to a significant increase in the survival rate. One major risk is amputation of extremities.
  
  
  METHODS
  The present report concerns a series of four patients (all male; mean age, 19 years) whose lower limb extremities were salvaged by the use of free flaps in the feet. In total, six flaps were performed (mean per patient, 1.7): three latissimus dorsi, two serratus anterior, and one combination latissimus dorsi/serratus anterior.
  
  
  RESULTS
  There were no flap failures, and the results are favorable after a mean follow-up of 25.5 months (range, 18 to 34 months), with all patients able to walk normally.
  
  
  CONCLUSIONS
  Although microsurgery of this type has been criticized when performed in cases of purpura fulminans, the authors' series indicates that it can be particularly effective.
authors.affiliation: Service de Chirurgie Plastique et Reconstructrice, Hopital Jean Monnet, CHU, 44 093, Nantes, France. f.duteille@voila.fr
authors.forename: Franck
authors.initials: F
authors.lastname: Duteille
authors.forename: Freddy
authors.initials: F
authors.lastname: Thibault
authors.forename: Pierre
authors.initials: P
authors.lastname: Perrot
authors.forename: Benoit
authors.initials: B
authors.lastname: Renard
authors.forename: Michel
authors.initials: M
authors.lastname: Pannier
mesh_terms: D000328:Adult; D003646:Debridement; D005531:Foot Deformities, Acquired / Q000209:etiology*; D005534:Foot Diseases / Q000601:surgery*; D006801:Humans; D011695:IgA Vasculitis / Q000601:surgery*; D008297:Male; D009336:Necrosis; D019651:Plastic Surgery Procedures; D020127:Recovery of Function; D013524:Surgical Flaps / Q000098:blood supply; D016896:Treatment Outcome