[Patient with homozygous sickle cell disease and free flap surgery: Ensuring the success of the procedure]. / Drépanocytose homozygote et nécessité d'une réparation par lambeau libre : comment assurer la réussite du projet thérapeutique.
Ann Chir Plast Esthet
; 62(2): 171-175, 2017 Apr.
Article
em Fr
| MEDLINE
| ID: mdl-27692921
ABSTRACT
Sickle cell anaemia is rare in France but frequent in Africa, leading to rigid, sickle-like shape red blood cells which bind together blocking microcirculation under certain circumstances. The vaso-occlusive crisis is the most frequent clinical manifestation especially in case of homozygous disease. Sickle cells disease is therefore usually considerated as a contraindication to microsurgery, however sometimes, a free flap procedure is mandatory. We here report the case of a 47-year-old man suffering with homozygous sickle cell anaemia and needing an antebrachial free flap procedure for a tongue reconstruction. The postoperative course was unremarkable apart from a delayed healing which is common in this particular localization. A review of the litterature allows to list the precautions to be taken to ensure a microsurgical procedure with this medical background. The preoperative examination has to assess usual sickle cell disease comorbidities such as kidney failure, heart failure or pulmonary hypertension. All the events leading to either low output syndrome, hypoxia, hypothermia, or a stress caused by uncontrolled pain should be avoided per- and postoperatively. With an optimum medical care, microsurgery is possible even in patients suffering with sickle cells anaemia. This case is rare in France but will become frequent in Africa with the improvement of the healthcare system, allowing to give all patients the best medical care.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
/
Língua
/
Procedimentos de Cirurgia Plástica
/
Doenças Raras
/
Retalhos de Tecido Biológico
/
Homozigoto
/
Anemia Falciforme
Tipo de estudo:
Etiology_studies
/
Risk_factors_studies
Limite:
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
Fr
Revista:
Ann Chir Plast Esthet
Ano de publicação:
2017
Tipo de documento:
Article