case_images: PMC10515656_01
case_images: A shows the amputated right forearm of the 38-year-old patient from a palmar view in the operating theatre before replantation. B demonstrates the corresponding x-ray.
case_images: ICRP_A_2259468_F0001_C.jpg
case_images: PMC10515656_01_ICRP_A_2259468_F0001_C.jpg
case_images: F0001
case_images: The amputated distal forearm was correctly wrapped in saline-saturated gauze in a plastic bag cooled on ice and brought to our emergency room (Figure 1).
case_images: A shows swelling and venous congestion accompanied by necrotic wound areas of the distal forearm 7 days after replantation owing to partially thrombosed arterial and vein grafts. B is a close-up view of necrotic wound edges showing fungus adjacent to the Coldex skin substitute.
case_images: ICRP_A_2259468_F0002_C.jpg
case_images: PMC10515656_01_ICRP_A_2259468_F0002_C.jpg
case_images: F0002
case_images: Intraoperatively multiple thrombosis of all blood vessels was demonstrated with avital extensor and flexor muscles with visible additional superficial fungal contamination, especially in the distal aspects of the wound (Figure 2).
case_images: A demonstrates the final x-ray after serial debridement. After erradication of infection the ulna was shortened to a remaining stump of 7 centimeters, the radius was completely resected. B shows the immediate postoperative situs after a fasciocutaneous hatchet flap and meshed skin graft.
case_images: ICRP_A_2259468_F0003_C.jpg
case_images: PMC10515656_01_ICRP_A_2259468_F0003_C.jpg
case_images: F0003
case_images: Eventually, closure of the skin defect by a fasciocutaneous hatchet flap and meshed skin graft took place 5 weeks after the initial trauma with a remaining ulnar stump length of 7 centimeters (Figure 3).