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CC BY-NC 4.0 · Arch Plast Surg 2012; 39(02): 150-153
DOI: 10.5999/aps.2012.39.2.150
Case Report

A Case of Heel Reconstruction with a Reverse Sural Artery Flap in a Hemophilia B Patient

Byung Kwon Lee
Department of Plastic and Reconstructive Surgery, Catholic University of Daegu School of Medicine, Daegu, Korea
,
Jeong Su Shim
Department of Plastic and Reconstructive Surgery, Catholic University of Daegu School of Medicine, Daegu, Korea
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Hemophilia B is a rare blood coagulation disorder. Complications such as bleeding and hematoma can cause necrosis of flaps, wound disruption, and the disturbance of wound healing. In particular, guidelines for flap operations in hemophilia B patients have still not been defined, and case reports are rare. We reconstructed the heel of a 41-year-old male hemophilia B patient using a reverse sural artery flap operation. The patient presented with mild hemophilia, having 27% of the normal value of coagulation factor IX. Coagulation and the changing value of the coagulation factor were regularly measured, and 70% of the normal value of coagulation factor IX was maintained through the injection of recombinant coagulation factors and antihemorrhagics. Hematoma developed twice (postoperative day [POD] 5 and POD 7) and in each case the hematoma was removed. Injections of recombinant coagulation factors and antihemorrhagics were continuously administered until postoperative week 2. When the coagulation factors were within normal ranges. In this article, a hemophilia B patient underwent reverse sural artery flap surgery and the healing progress was analyzed. We conclude that higher than baseline levels of coagulation factors are needed for successful healing in reverse sural artery flap surgery.

Keywords

Hemophilia B - Heel - Surgical flaps - Blood coagulation disorders - Factor IX


Publication History

Received: 24 October 2011

Accepted: 05 February 2012

Article published online:
24 April 2022

© 2012. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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  • REFERENCES

  • 1 Lee DN, Oh YJ, Kyung YS. et al. A case of repeated cesarean section on the patient who has a moderate hemophilia B. Korean J Obstet Gynecol 2003; 46: 2317-2322
    Google Scholar
  • 2 Jin KN, Lee W, Yin YH. et al. Preoperative evaluation of lower extremity arteries for free fibula transfer using MDCT angiography. J Comput Assist Tomogr 2007; 31: 820-825
    CrossrefPubMedGoogle Scholar
  • 3 Kurachi K, Yao SN, Furukawa M. et al. Deficiencies in factors IX and VIII: what is now known. Hosp Pract (Off Ed) 1992; 27: 41-51
    Google Scholar
  • 4 Ozkan O, Chen HC, Mardini S. et al. Microvascular free tissue transfer in patients with hematological disorders. Plast Reconstr Surg 2006; 118: 936-944
    CrossrefPubMedGoogle Scholar
  • 5 Knott PD, Khariwala SS, Minarchek J. Hemophilia B and free tissue transfer: medical and surgical management. Ann Plast Surg 2005; 54: 336-338
    PubMedGoogle Scholar
  • 6 Bae DK, Yim CM, Jeon MH. et al. TKA in hemophilic arthropathy of the knee. J Korean Orthop Assoc 1999; 34: 489-494
    CrossrefGoogle Scholar
  • 7 Lee HJ, Jun JH, Kim KH. et al. Anesthetic management of a patient with hemophilia B. Korean J Anesthesiol 2004; 46: 376-377
    CrossrefGoogle Scholar