Serhan TUNCER, M.onur ÇUKUROĞLU, Kemal FINDIKÇIOĞLU, Sühan AYHAN, Osman LATİFOĞLU

KAÇIŞ FENOMENİ NEDENİYLE OLUŞAN ÜST EKSTREMİTE ÜLSERLERİ: İKİ OLGU SUNUMU

Kronik böbrek yetmezliği olan hastalarda diyaliz için oluşturulan arteriovenöz fistül üst ekstremitede kaçış fenomeni olarak bilinen iskemik değişikliklere yol açabilir. Bu durum sonucunda gelişen yumuşak doku defektlerinin rekonstrüksiyonu oldukça zordur. Kaçış fenomeni ve kronik hastalığın etkileri hem yara iyileşmesini geciktirir hem de rekonstrüksiyonda uygulanacak greft, lokal, pediküllü ya da serbest fleplerde başarı oranlarının düşmesine sebep olur. Bu yazıda kronik böbrek yetmezliği olan ve arteriovenöz fistül bulunan üst ekstremitelerinde yumuşak doku defekti oluşan iki olgu sunulmuştur. Öncelikle kaçış fenomeni bulunan koldaki arteriyovenöz fistülü kapatılarak karşı kola taşınmış ve ekstremite dolaşımının düzelmesi sağlanmıştır. Iskeminin düzelmesiyle birlikte bir hastada, yarada kendiliğinden iyileşme görülürken diğer hastada doku defekti kasık flebiyle onarılmıştır.

Anahtar Kelimeler:

Kaçış fenomeni, cilt ülserasyonu

UPPER EXTREMITY ULCERS DUE TO STEAL PHENOMENON: TWO CASE REPORTS

Arteriovenous fistulas generated in chronic renal failure patients may cause ischemic changes at the upper extremity and this situation is known as steal phenomenon. Reconstruction of the soft tissue defects arise due this condition can be troublesome. Steal phenomenon and effect of chronic disease interfere with wound healing and decreases the success rates in reconstruction with graft, local, pedicled or free flaps. In this study two cases that have chronic renal failure and complain about soft tissue defect on the upper extremity with arteriovenous fistulas are presented. Arteriovenous fistula on the extremity with steal phenomenon is closed initially in order to improve the circulation and a new one is created on the opposite side. After the ischemic problem was solved, spontaneous wound healing was seen in the first case and the other patient was treated with a distant groin flap.

Keywords:

steal phenomenon, skin ulceration,

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