title: Particular catastrophic antiphospholipid syndrome, on the sole surgical site after breast reduction.
abstract: A 20-year-old woman treated with vitamin K antagonist for antiphospholipid syndrome (APS) (pulmonary embolisms at age 15) was admitted for breast reduction after bridging therapy. At 2 days post-surgery haematomas appeared on the surgical site and anticoagulant therapy was withheld. She developed a skin and breast necrosis leading to the diagnosis of catastrophic APS. Despite medical treatment (anticoagulant therapy, corticosteroids and intravenous immunoglobulins) and surgery, necrosis continued. After 2 weeks of negative-pressure wound therapy (V.A.C.(®) Therapy™) the patient improved, mammary tissues were alive, well vascularised and budding. Breast reconstruction was then initiated. Artificial dermis graft (MatriDerm(®) 2 mm) was applied, and 3 weeks later the apposition of split-thickness skin graft on it. Six months later, results of the surgery were good and the patient was satisfied.
authors.affiliation: Nancy University Hospital, Department of Maxillofacial, Plastic, Reconstructive and Cosmetic Surgery, Nancy, France. Electronic address: antoine@email.com.
authors.forename: Antoine
authors.initials: A
authors.lastname: de Runz
authors.forename: Stephane
authors.initials: S
authors.lastname: Zuily
authors.forename: Jessica
authors.initials: J
authors.lastname: Gosset
authors.forename: Denis
authors.initials: D
authors.lastname: Wahl
authors.forename: Etienne
authors.initials: E
authors.lastname: Simon
mesh_terms: D000328:Adult; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000188:drug therapy; D001940:Breast / Q000002:abnormalities / Q000473:pathology* / Q000601:surgery; D001941:Breast Diseases / Q000209:etiology*; D005260:Female; D006406:Hematoma / Q000209:etiology* / Q000628:therapy; D006801:Humans; D006984:Hypertrophy / Q000150:complications / Q000601:surgery; D016462:Mammaplasty / Q000009:adverse effects; D009336:Necrosis / Q000209:etiology / Q000628:therapy; D054843:Negative-Pressure Wound Therapy; D012867:Skin / Q000473:pathology*; D016038:Skin Transplantation; D055815:Young Adult
keywords: Antiphospholipid syndrome; Mammaplasty; Negative-pressure wound therapy; Skin artificial; Skin necrosis; Skin transplantation