RESUMO
PURPOSE: Frostbite is often managed conservatively; however, in severe cases, microsurgical free tissue transfer is required for soft tissue coverage and limb salvage. Given its rarity, the techniques and outcomes of these cases are not well described. The purpose of this report is to present the largest case series, to date, of frostbite injuries requiring microsurgical reconstruction for limb salvage. METHODS: A single-center retrospective review was conducted of all patients who underwent free tissue transfer by a single surgeon from 2008 to 2022. Patients of all ages were included if they suffered a frostbite injury requiring free tissue transfer. Demographics, operative details, and surgical outcomes were recorded. RESULTS: Eight patients with frostbite injuries were included in the report. Patients had frostbite injuries either to the lower extremities (n = 4) or to both upper and lower extremities (n = 4). Sixteen free flaps were done in total including four paired chimeric and eight single free flaps. Flap recipient sites included knees (n = 5), foot/ankle (n = 3), dorsal hands (n = 2), and thumbs (n = 2). All 16 flaps survived. Five patients had complications: four with major complications requiring operative management and two with minor complications requiring conservative management. Mean follow-up time was 505.7 days (range 115-1564). All lower extremity reconstructions were able to weight-bear at an average of 125.2 days post-injury (range 87-164). CONCLUSIONS: This case series demonstrates that free tissue transfer is a robust option for soft tissue coverage and functional limb salvage in patients with severe frostbite injuries to both upper and lower extremities.
Assuntos
Retalhos de Tecido Biológico , Congelamento das Extremidades , Salvamento de Membro , Microcirurgia , Procedimentos de Cirurgia Plástica , Humanos , Congelamento das Extremidades/cirurgia , Estudos Retrospectivos , Salvamento de Membro/métodos , Retalhos de Tecido Biológico/transplante , Masculino , Feminino , Adulto , Microcirurgia/métodos , Procedimentos de Cirurgia Plástica/métodos , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem , Adolescente , Escala de Gravidade do Ferimento , Lesões dos Tecidos Moles/cirurgia , CriançaRESUMO
Recently, plastic surgery lost one of its most prominent surgeons-Dr. Hanno Millesi. His contributions to the field continue to impact the practice of medicine and surgery. As such, it is appropriate to reflect upon his career and recognize his accomplishments in peripheral nerve surgery, hand surgery, and Dupuytren disease.