Free tissue transfer in patients with systemic lupus erythematosus

Systemic lupus erythematosus is a non-organ specific, autoimmune disease ch aracterised by antinuclear antibodies and vasculitis. This may manifest its elf with areas of cutaneous necrosis which may require extensive excision a nd reconstruction. Major areas of skin and soft tissue loss may require cov erage with either local or microvascular free tissue transfer. This present s potential difficulties in patients with generalised vasculitis. We presen t the case of a professional cellist with extensive soft tissue loss in her dominant hand, successfully reconstructed with a free latissimus dorsi mus cle flap, treated with peri- and postoperative anticoagulation and corticos teroids. (C) 2000 The British Association of Plastic Surgeons.