title: Freestyle Perforator-Based Fasciocutaneous Flap Reconstruction in Nicolau Syndrome-Related Tissue Necrosis.
abstract: The actual pathology of the Nicolau syndrome (NS) is still unknown. It is thought to involve direct vascular damage and vasospasm. Many NS cases were reported in the literature but a treatment protocol is still not established. However, after demarcation of the necrotic tissue, surgical intervention is mandatory. Five NS cases with extensive tissue necrosis on the upper lateral gluteal region were analyzed retrospectively. Operative technique was described in details for freestyle perforator-based fasciocutaneous flaps from the gluteal region to reconstruct defects of NS-related tissue necrosis. Freestyle perforator-based fasciocutaneous flaps were used for defect closure in all patients. All flaps survived totally. No complications occurred during the follow-up period. Although rare, NS is a serious complication of inadvertent intramuscular injections. Prevention is the best treatment. However, in case of large-tissue necrosis, freestyle perforator-based fasciocutaneous flaps harvested from the gluteal region is a satisfactory option for reconstruction.
authors.affiliation: Department of Plastic and Reconstructive Surgery, School of Medicine, Eskisehir Osmangazi University, Meselik, 26480 Eskisehir, Turkey.
authors.forename: Emre A
authors.initials: EA
authors.lastname: Kocman
authors.affiliation: Department of General Surgery, School of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey.
authors.forename: Fatih N
authors.initials: FN
authors.lastname: Yaşar
authors.affiliation: Department of Plastic and Reconstructive Surgery, School of Medicine, Eskisehir Osmangazi University, Meselik, 26480 Eskisehir, Turkey.
authors.forename: Aydan A
authors.initials: AA
authors.lastname: Kose
authors.affiliation: Plastic Surgery Clinic, Diyarbakir Military Hospital, Diyarbakir, Turkey.
authors.forename: Yakup
authors.initials: Y
authors.lastname: Cil
authors.affiliation: Department of Plastic and Reconstructive Surgery, School of Medicine, Eskisehir Osmangazi University, Meselik, 26480 Eskisehir, Turkey.
authors.forename: Yakup
authors.initials: Y
authors.lastname: Karabagli
authors.affiliation: Department of Plastic and Reconstructive Surgery, School of Medicine, Eskisehir Osmangazi University, Meselik, 26480 Eskisehir, Turkey.
authors.forename: Cengiz
authors.initials: C
authors.lastname: Çetin
keywords: Freestyle perforator-based fasciocutaneous flap; Inadvertent drug injection; Nicolau syndrome; V-Y flaps