Loss of the replanted thumb by drug-induced ergotism
Coppeneur-Krieger, C.; Plock, E.B.; Neugebauer, R.
Handchirurgie Mikrochirurgie Plastische Chirurgie Organ der Deutschsprachigen Arbeitsgemeinschaft für Handchirurgie Organ der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der Peripheren Nerven und Gefasse Organ der V. 27(3): 137-140
1995
ISSN/ISBN: 0722-1819 PMID: 7622127 Document Number: 454095
Vasospastic reactions are known to be a complication of thromboembolic prophylaxis with Heparin-dihydroergotamine. We describe a rare case after successful replantation of an amputated thumb. On the third day after surgery, Heparin-dihydroergotamine was administered once. Within three hours, the thumb turned pale and cold. At revision, a spasm of the artery proved to be the cause of ischemia. Therapeutic efforts were unsuccessful, even intraarterial injection of Prostaglandin E1 and the interposition of a vein graft. Amputation became necessary. Because of the possible complication with ergotism and the consequence of a failed replantation, we suggest not to use Heparin-dihydroergotamine for thromboembolic prophylaxis in microsurgery.