Sinem CILINGIR, Polat BICICI, Alper AKSOY
Turkish Journal of Plastic Surgery - 2026;34(1):47-49
Buerger's disease, or thromboangiitis obliterans, is a condition that causes occlusion of small and medium-sized arteries, mostly affecting young males, and leads to limb loss. Managing critical limb ischemia and achieving effective limb salvage still remains challenging. We present the case of a 56-year-old patient suffering from severe, treatment-resistant Buerger's disease complicated by gangrene of the left foot. Following failed medical treatment and an angioplasty procedure, limb salvage was managed by a free anterolateral thigh flap. The pedicle was anastomosed end-to-side to the anterior tibial artery and end-to-end to the two accompanying veins. The patient had an uneventful postoperative recovery, and during the 3-year follow-up, no ulcer recurrence was observed. In conclusion, this report demonstrates the long-term success of a free flap in salvaging a limb with advanced, treatment-resistant Buerger's disease, a scenario where amputation is often considered inevitable. This case underscores a critical consideration for clinical practice; in suitable patients with Buerger's disease, free flap reconstruction should be recognized as a viable limb-sparing alternative before proceeding with amputation.
