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The importance of early surgical intervention in the treatment of necrotizing vasculitis


Authors: L. Bébarová;  T. Řezáč;  M. Stašek;  F. Skopal;  D. Klos;  Č. Neoral
Authors‘ workplace: I. chirurgická klinika LF UP a FN Olomouc, přednosta: doc. MUDr. Čestmír Neoral, CSc.
Published in: Rozhl. Chir., 2012, roč. 91, č. 2, s. 87-89.
Category: Case Report

Overview

Vasculitides are an etiologically heterogeneous group of vascular affections leading to vascular wall damage followed by ischaemia of the tissues supplied by the affected vessels. Damage to the vessels of lower extremities is frequent; in serious cases a complete destruction of soft tissue as well as skeletal lesions may occur. This then results in a situation which, without a well-timed surgical intervention, often requires an amputation of the limb.

We are presenting a case of a 61-year-old female patient with a large plantar defect of the right foot and gangrene of three toes of the same limb which developed as a result of necrotizing vasculitis.

Key words:
necrotizing vasculitis – surgical intervention – wet healing


Sources

1. Fiorentino DF. Cutaneous vasculitis. Journal of the American Academy of Dermatology 2003;311–342.

2. Savage et al. Vasculitis. BMJ 320:1325, bmj.com (Published 13 May 2000).

3. Fikri et al. Awaiting Autoamputation: A Primary Management Strategy for Toe Gangrene in Diabetic Foot Disease. Diabetes Care August 2011 vol. 34 no. 8 e134.

4. Markusse HM et al. Polyneuropathy as initial manifestation of necrotizing vasculitis and gangrene in systemic lupus erythematosus. 1991;(5–6):204–8.

5. Yeager RA et al. Predictors of outcome of forefoot surgery for ulceration and gangrene. 1998; 175(5):388–90.

6. Svensson H. et al. Minor amputation in patients with diabetes mellitus and severe foot ulcers achieves good outcomes. 2011;(6):261–2,264,266.

7. Wasner G. et al. Complex regional pain syndrome – diagnostic, mechanisms, CNS involvement and therapy. Spinal Cord 2003;41:61–75.

8. Pavel Klener et al. Vnitřní lékařství. Praha, Galén, 2006.

Labels
Surgery Orthopaedics Trauma surgery
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