UPPER EXTREMITY ULCERS DUE TO STEAL PHENOMENON: TWO CASE REPORTS

Arteriovenous fistulas generated in chronic renal failure patients may cause ischemic changes at the upper extremity and this situation is known as steal phenomenon. Reconstruction of the soft tissue defects arise due this condition can be troublesome. Steal phenomenon and effect of chronic disease interfere with wound healing and decreases the success rates in reconstruction with graft, local, pedicled or free flaps. In this study two cases that have chronic renal failure and complain about soft tissue defect on the upper extremity with arteriovenous fistulas are presented. Arteriovenous fistula on the extremity with steal phenomenon is closed initially in order to improve the circulation and a new one is created on the opposite side. After the ischemic problem was solved, spontaneous wound healing was seen in the first case and the other patient was treated with a distant groin flap.