Background: Purpura fulminans remains a severe and potentially life-threatening disorder, despite advances in intensive care that have led to a significant increase in the survival rate. One major risk is amputation of extremities.
Methods: The present report concerns a series of four patients (all male; mean age, 19 years) whose lower limb extremities were salvaged by the use of free flaps in the feet. In total, six flaps were performed (mean per patient, 1.7): three latissimus dorsi, two serratus anterior, and one combination latissimus dorsi/serratus anterior.
Results: There were no flap failures, and the results are favorable after a mean follow-up of 25.5 months (range, 18 to 34 months), with all patients able to walk normally.
Conclusion: Although microsurgery of this type has been criticized when performed in cases of purpura fulminans, the authors' series indicates that it can be particularly effective.
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