Use of a near‐infrared vein visualization device in partial second toe pulp flap transfer for fingertip reconstruction

Although sickle cell disease has long been viewed as a contraindication to free flap transfer, little data exist evaluating complications of microsurgical procedures in the sickle cell trait patient. Reported is the case of a 55-year-old woman with sickle cell trait who underwent a deep inferior epigastric perforator (DIEP) microvascular free flap following mastectomy. The flap developed signs of venous congestion on postoperative day two but was found to have patent arterial and venous anastomoses upon exploration in the operating room. On near-infrared indocyanine green angiography, poor vascular flow was noted despite patent anastomoses and strong cutaneous arterial Doppler signals. Intrinsic microvascular compromise or sickling remains a risk in the sickle cell trait population as it does for the sickle cell disease population. Just like in sickle cell disease patients, special care should be taken to optimize anticoagulation and minimize ischemia-induced sickling for patients with sickle cell trait undergoing microsurgery.

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Second toe lateral hemipulp flap transfer to cover third toe pulp defect

Journal of Plastic Reconstructive & Aesthetic Surgery ◽

10.1016/j.bjps.2013.11.007 ◽

2014 ◽

Vol 67 (4) ◽

pp. e120-e121 ◽

Cited By ~ 1

Author(s):

Kensuke Tashiro ◽

Mitsunaga Narushima ◽

Takumi Yamamoto ◽

Takuya Iida ◽

Isao Koshima

Keyword(s):

Flap Transfer ◽

Second Toe

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Donor-Site Morbidity after Partial Second Toe Pulp Free Flap for Fingertip Reconstruction

Archives of Plastic Surgery ◽

10.5999/aps.2016.43.1.66 ◽

2016 ◽

Vol 43 (1) ◽

pp. 66-70 ◽

Cited By ~ 6

Author(s):

Hyung Su Kim ◽

Dong Chul Lee ◽

Jin Soo Kim ◽

Si Young Roh ◽

Kyung Jin Lee ◽

...

Keyword(s):

Free Flap ◽

Donor Site ◽

Donor Site Morbidity ◽

Fingertip Reconstruction ◽

Second Toe

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Reverse Midpalmar Island Flap Transfer for Fingertip Reconstruction

Journal of Reconstructive Microsurgery ◽

10.1055/s-0028-1103506 ◽

2008 ◽

Vol 25 (03) ◽

pp. 171-179 ◽

Cited By ~ 11

Author(s):

Shohei Omokawa ◽

Ryotaro Fujitani ◽

Yoshihiro Dohi ◽

Yasuhito Tanaka ◽

Hiroshi Yajima

Keyword(s):

Island Flap ◽

Flap Transfer ◽

Fingertip Reconstruction

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Esthetically successful fingertip reconstruction using a second toe pulp free flap with a split thickness skin graft and tattoo

Journal of Plastic Reconstructive & Aesthetic Surgery ◽

10.1016/j.bjps.2016.05.031 ◽

2016 ◽

Vol 69 (11) ◽

pp. 1574-1576 ◽

Cited By ~ 3

Author(s):

Yoon Jae Lee ◽

Hak Young Kim ◽

En Young Rha ◽

Jun Yong Lee ◽

Hyun Ho Han

Keyword(s):

Skin Graft ◽

Free Flap ◽

Split Thickness Skin Graft ◽

Thickness Skin ◽

Fingertip Reconstruction ◽

Second Toe

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Microsurgery in the sickle cell trait population: is it actually safe?

BMJ Case Reports ◽

10.1136/bcr-2020-234924 ◽

2020 ◽

Vol 13 (5) ◽

pp. e234924

Author(s):

Paul F Abraham ◽

Omar Allam ◽

Kitae Eric Park ◽

Michael Alperovich

Keyword(s):

Sickle Cell Disease ◽

Sickle Cell ◽

Free Flap ◽

Near Infrared ◽

Sickle Cell Trait ◽

Cell Disease ◽

Flap Transfer ◽

Free Flap Transfer ◽

Patient Reported ◽

Deep Inferior Epigastric Perforator

Although sickle cell disease has long been viewed as a contraindication to free flap transfer, little data exist evaluating complications of microsurgical procedures in the sickle cell trait patient. Reported is the case of a 55-year-old woman with sickle cell trait who underwent a deep inferior epigastric perforator microvascular free flap following mastectomy. The flap developed signs of venous congestion on postoperative day 2 but was found to have patent arterial and venous anastomoses on exploration in the operating room. On near-infrared indocyanine green angiography, poor vascular flow was noted despite patent anastomoses and strong cutaneous arterial Doppler signals. Intrinsic microvascular compromise or sickling remains a risk in the sickle cell trait population as it does for the sickle cell disease population. Just like in sickle cell disease patients, special care should be taken to optimise anticoagulation and minimise ischaemia-induced sickling for patients with sickle cell trait undergoing microsurgery.

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