J Reconstr Microsurg 2009; 25(4): 233-236
DOI: 10.1055/s-0028-1104552
© Thieme Medical Publishers

Functional and Aesthetic Outcome of a Complex Upper-Limb Reconstruction after Criminal Caustic Injection

Calin Constantin Lazar1 , M. Revol2 , J-M. Servant2
  • 1Department of Plastic and Reconstructive Surgery, René Dubos Hospital, Pontoise, France
  • 2Department of Plastic, Reconstructive and Aesthetic Surgery, Saint Louis University Hospital, Paris, France
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Publikationsdatum:
05. Dezember 2008 (online)

ABSTRACT

Extensive upper-limb injuries are usually secondary to accidental partial or complete avulsions or massive burns. Caustic injections are an exceptional etiology, with terrible lesions that present therapeutic challenges and major aftereffects. We report the case of a 41-year-old patient presenting with a large and deep anterior necrosis of the upper-limb anterior tissues, after a criminal intravenous injection of caustic soda on the inner side of his left elbow. Reconstruction methods consisted of a homolateral latissimus dorsi pediculated flap, a humeroulnar vascular bypass, a medial nerve autograft, and a secondary palliative Brand 1 procedure. Final functional and aesthetic results, obtained after long-term physiotherapy, were unexpectedly good. In conclusion, reconstructive surgery of such major lesions cannot be considered without a multidisciplinary approach. Moreover, patients have to be well informed about the necessity of multiple surgical interventions, the risk of major handicap, and the unpredictable nature of the final outcome.

REFERENCES

Calin Constantin Lazar, M.D. 

Department of Plastic and Reconstructive Surgery, René Dubos Hospital

95303 Pontoise, France

eMail: lazarcalin@yahoo.fr