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CC BY-NC-ND 4.0 · J Reconstr Microsurg Open 2021; 06(01): e40-e44
DOI: 10.1055/s-0041-1729955
Case Report

Successful Microsurgical Reconstruction for Limb Salvage in a COVID-19-Positive Patient: A Case Report

Christopher M. Fleury
1   Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia
,
Brian L. Chang
1   Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia
,
Robert P. Slamin
1   Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia
,
Jonathan A. Schwitzer
1   Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia
,
Arjun Kanuri
1   Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia
,
Derek L. Masden
2   Department of Plastic Surgery, MedStar Washington Hospital Center, Washington, District of Columbia
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Abstract

Background Although the novel 2019 coronavirus (COVID-19) pandemic delayed elective microsurgical reconstruction cases, traumatic injuries requiring microsurgical reconstruction for limb salvage still presented to our hospital. Recent data suggests a link between COVID-19 and increased venous and arterial thromboembolic events, theoretically increasing the risk of microvascular anastomotic thrombosis and flap failure.

Methods We provide a single case report of microsurgical limb salvage in a COVID-19-positive patient with a Gustilo IIIb open tibial-fibular fracture.

Results A free latissimus dorsi muscle flap was used to successfully cover a Gustilo IIIb open tibial-fibular fracture with exposed orthopedic hardware and large soft tissue defect, with 5-month follow-up demonstrating a well-healed flap allowing for preserved ambulation.

Conclusion Although there is a theoretical increased incidence of venous and arterial thrombotic microvascular failure in COVID-19-positive patients, microsurgical reconstruction is occasionally the lone option for salvage. Microsurgical reconstruction in this population must be carefully considered, meticulously executed, and closely monitored.

Keywords

microsurgery - COVID-19 - limb salvage

Financial Disclosure Statement

The authors have no financial disclosures.




Publication History

Received: 07 January 2021

Accepted: 03 March 2021

Article published online:
15 June 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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