Using free flaps for reconstruction during infections by mucormycosis: A case report and a structured review of the literature

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• 作者：C. Reinbold ; ^{c.reinbold@hotmail.fr" class="auth_mail" title="E-mail the corresponding author} ; M. Derder ; M. Hivelin ; C. Ozil ; A. Al Hindi ; L. Lantieri
• 关键词：Mucormycosis ; Free flap ; Reconstruction ; Upper limb trauma ; Infection ; DIEP
• 刊名：Annales de chirurgie plastique esthetique
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：61
• 期：2
• 页码：153-161
• 全文大小：2177 K

文摘

Mucormycosis is a very rare infection caused by fungi from the order Mucorales, it rarely involves the skin. We report a case of necrotizing fasciitis of the upper limb which required an aggressive surgical debridement, antifungal therapy and coverage of the defect with a free DIEP flap, a review of the literature was also done regarding indications of reconstruction with free flaps.

Case presentation

Here we present a case of cutaneous mucormycosis of the right upper limb in a 49-year-old immunocompetent woman after having an open fracture associated with massive contamination during a motor vehicle collision. In early postoperative period, she had multiple skin necrotic lesions. Serial surgical debridements were performed and ended up with interscapular-thoracic amputation associated with a total mastectomy. Following diagnosis confirmation of mucormycosis infection, the patient was started on antifungal therapy for several months. After disease control, the large defect was successfully covered by a DIEP flap.

Conclusion

Cutaneous mucormycosis requires antifungal therapy along with aggressive debridement, reconstruction by a free flap seems to be a good solution to cover these large defects.