Toxic shock syndrome complicated with symmetrical peripheral gangrene after liposuction and fat transfer: a case report and literature review

Abstract

Background Liposuction is one of the most commonly performed aesthetic procedures. Toxic shock syndrome(TSS) is a rare, life-threatening complication. The incidence rate of TSS is very low in the plastic surgery field, especially after liposuction and fat transfer. Case presentation A 23-year-old female patient was transferred to our emergency department from an aesthetic clinic with sepsis shock features after received liposuction and fat transfer. The patient underwent TSS, disseminated intravascular coagulation(DIC), multiple organ dysfunction syndrome (MODS), symmetrical peripheral gangrene (SPG), and necrotizing soft tissue infection of the buttocks in the next 10 days. Authors used a series of debridement and reconstructive surgery including vacuum sealing drainage (VSD) treatment, artificial dermis grafts,split-thickness skin grafts, amputation surgeries when her vital signs were stable. The patient experienced desquamation of the hand on the 26th day. The skin grafts survived and the function of both fingers and toes recovered. She was discharged 2 months after admission and was in good health. Conclusion TSS is extremely rare in the field of liposuction and autologous fat transfer. The mortality rate of TSS is very high. Early diagnosis and operative treatment, as well as correction of systemic abnormalities, are the important keys to save a patient's life.

Effect and mechanism of Magnolia officinalis pharmacopuncture for treating localized fat via network pharmacology and experimental study

“… 13 Recently, non-invasive treatment for localized fat reduction is necessary not only for esthetic purposes but also for therapeutic purposes. 7 Based on the previous studies, MO shows a wide range of pharmaceutical activities, especially inhibiting effect against fat accumulation. 7 , 14 Network pharmacology is an emerging bioinformatic tool in drug discovery and development.…”

“… 7 Based on the previous studies, MO shows a wide range of pharmaceutical activities, especially inhibiting effect against fat accumulation. 7 , 14 Network pharmacology is an emerging bioinformatic tool in drug discovery and development. 15 Via functional enrichment analysis, biological functions of traditional medicine containing numerous multi-targeted chemicals could be evaluated.…”

“…According to the previous literatures, main compounds of MO, honokiol and magnolol, improve liver dysfunction hepatic steatosis via AMPK-SREBP-1c pathway in HFD-induced mice. 7 Magnolol has been studied to upregulate AKT, AMPK, and PPARα expression and suppress SREBP-1c generation. 17 AMPK is a key factor in regulating lipid metabolism, and the AMPK pathway is associated with a fatty acid synthesis and cholesterol synthesis in the localized area.…”

“…However, lethal complications including necrotizing fasciitis, toxic shock syndrome, fat embolism syndrome, and even death could be accompanied with the liposuction procedure. 7 For that reason, there is an increasing need for new treatments to treat localized fat tissue without side effects. In this respect, there are herbs with a long history of use have little toxicity and have the effect of promoting appetite loss and weight loss.…”

“…Commonly, treatments using natural substances have been regarded as a safer and more economical alternative to weight loss. 7 Pharmacopuncture is a common acupuncture technique in traditional Korean Medicine. 8 This technique has been used as a non-surgical alternative to treat a localized obesity.…”