3/2023 4/2023

Skin graft ing on amputated lower limb,norepinephrine-induced ischemic limbnecrosis – case report

K. Efthymiou, J. Kaťuchová, J. Radoňak, M. Kňazovický, J. Iľková, D. Tomašurová

1st Department of Surgery, Faculty of Medicine, Pavol Jozef Šafárik University in Košice and University Hospital Košice, Slovakia


Ischemic limb necrosis due to high dose of norepinephrine (NE) in a patient with septic shock is uncommon. Unfortunately, amputation of necrotic parts is the only available treatment. Reconstruction with skin autografts for defects resulting from the amputation of the lower limbs is challenging. Herein we report a case of digit necrosis in the upper and lower limbs after administration of a high dose of NE > 1 μcg/kg/min in a patient with septic shock. The source of infection that led to septic shock was not detected. Surgical amputation was performed as it was impossible to repair impaired vasculature and patients’ life was endangered. Large defects were covered with skin autografts from the patient’s thighs. The included figures demonstrate the extremities’ appearance before, after amputation, during and after skin graft transplantation.

Key words

skin graft – reconstruction – amputation – septic-shock – sepsis – ischemia – norepinephrine

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