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

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 ven...

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Bibliographic Details
Published in:Journal of reconstructive microsurgery OPEN 2021-01, Vol.6 (1), p.e40-e44
Main Authors: Fleury, Christopher M., Chang, Brian L., Slamin, Robert P., Schwitzer, Jonathan A., Kanuri, Arjun, Masden, Derek L.
Format: Article
Language:English
Subjects:
Case Report
covid-19
limb salvage
microsurgery
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Summary: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.
ISSN:2377-0813
2377-0821
DOI:10.1055/s-0041-1729955