Salvaging limbs in cases of severe purpura fulminans: advantages of free flaps.
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.
Duteille
Franck
F
Service de Chirurgie Plastique et Reconstructrice, Hopital Jean Monnet, CHU, 44 093, Nantes, France. f.duteille@voila.fr
Thibault
Freddy
F
Perrot
Pierre
P
Renard
Benoit
B
Pannier
Michel
M
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