Iatrogenic-induced Peripheral Gangrene: From Multiple Limb Amputations to Prosthetic Restoration

Objectives: Multiple limb amputations are an uncommon complication from inotrope-induced peripheral gangrene. Case Presentation: A 20-year-old lady with valvular heart disease had septic shock secondary to infective endocarditis and required prolonged cardiopulmonary resuscitation. Despite aggressive fluid resuscitation, the patient triple strength intravenous noradrenaline maintain hemodynamic stability. On day 5 of post-shock, dry gangrene occurred in distal parts all limbs, inotrope was stopped. Although gangrenous changes were non-progressive, she a significant degree assistance mobility daily function performance. The counseled for multiple promote walking hand through prosthetic restoration. Five months after event, right transtibial amputation, left Chopart wrist disarticulation, second, third, fourth, fifth fingers amputation. Three specific goals inpatient rehabilitation independent short-distance ambulation prostheses, performing basic activities living adaptive devices, wheelchair propulsion long-distance using right-sided prosthesis, left-sided Syme's prosthesis Kingsley's foot, silicone-based cosmetic glove body-powered transradial prosthesis. Discussion: complication, may lead Following ultimate rehabilitative goal is restore capacity perform functions restoration, whether lower amputees or functioning upper amputees. Prescribing single loss relatively straightforward, but restoring bears many challenges toward successful recovery functions.