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L'anémie falciforme et la malaria a Plasmodium falciparum: une menace pour la survie des lambeaux?

Published in Annales de chirurgie plastique et esthétique. 1999, vol. 44, no. 1, p. 81-8
Abstract Plasmodium falciparum malaria, a parasitic disease, and sickle cell anemia, a hereditary disease, are two diseases affecting erythrocyte cycle, occurring with a high prevalence in tropical Africa. They may induce microthrombosis inducing vaso-occlusion, organ dysfunction and flap necrosis. During the acute phase of Plasmodium falciparum malaria, destruction of parasitized and healthy erythrocytes, release of parasite and erythrocyte material into the circulation, and secondary host reaction occur. Plasmodium falciparum infected erythrocytes also sequester in the microcirculation of vital organs and may interfere with microcirculatory flow in the flap during the postoperative period. The lower legs of homozygous sickle cell anemia patients are areas of marginal vascularity where minor abrasions become foci of inflammation. Inflammation results in decreased local oxygen tension, sickling of erythrocytes, increased blood viscosity and thrombosis with consequent ischemia, tissue breakdown and leg ulcer. Tissue transfer has become the procedure of choice for reconstruction of the lower third of the leg although flaps may become necrotic. The aim of this study is to analyse circumstances predisposing to surgical complications and to define preventive and therapeutic measures. A review of the literature will describe the current research and the new perspectives to treat sickle cell anemia, for example hydroxyurea and vasoactive substances (pentoxifylline, naftidrofuryl, buflomedil).
Keywords Anemia, Sickle Cell/blood/complications/drug therapyAntisickling Agents/therapeutic useChildHumansHydroxyurea/therapeutic useLeg Ulcer/etiologyMalaria, Falciparum/blood/complicationsPentoxifylline/therapeutic usePostoperative Complications/etiologyResearchRisk FactorsSurgical FlapsVasodilator Agents/therapeutic use
PMID: 10188298
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Research group Groupe Pittet Cuenod Brigitte (chirurgie plastique et reconstructive) (96)
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MARIETHOZ, Sophie et al. L'anémie falciforme et la malaria a Plasmodium falciparum: une menace pour la survie des lambeaux?. In: Annales de chirurgie plastique et esthétique, 1999, vol. 44, n° 1, p. 81-8. https://archive-ouverte.unige.ch/unige:72855

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Deposited on : 2015-05-28

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