DERMATOLOGICAL AND VASCULAR MANIFESTATIONS IN PATIENTS WITH EHLERS-DANLOS SYNDROME: IMPLICATIONS FOR RECONSTRUCTIVE VASCULAR SURGERY

Abstract

Introduction: Ehlers-Danlos syndrome is a group of genetic connective tissue disorders characterized by joint hypermobility, skin fragility, and vascular impairment. Dermatological and vascular manifestations are of particular relevance, as they can significantly influence surgical management in patients requiring reconstructive vascular surgery. Complications associated with these conditions, such as predisposition to hematoma, inadequate healing, and vascular ruptures, make the surgical approach challenging. Understanding the relationship between these manifestations and the implications for surgical procedures is crucial to optimize patient care and minimize risks. Objective: To investigate dermatological and vascular manifestations in patients with Ehlers-Danlos syndrome, focusing on the implications that these conditions have for reconstructive vascular surgery. The review sought to consolidate evidence that could guide clinical practice and improve surgical outcomes. Methodology: The methodology adopted was based on the PRISMA checklist and involved a search in databases such as PubMed, Scielo and Web of Science, using five descriptors: "Ehlers-Danlos syndrome", "dermatological manifestations", "vascular complications", "vascular surgery" and "connective tissue". The inclusion criteria consisted of studies published in the last ten years, which addressed patients with a confirmed diagnosis of the syndrome, focusing on surgical implications. On the other hand, articles that did not present relevant data on surgery, those that did not include human patients and non-systematic reviews were excluded. Results: Dermatological complications, such as skin fragility and poor healing, were frequently associated with higher rates of postoperative complications. Vascular manifestations, including vascular fragility, resulted in an increased risk of adverse events during and after procedures. In conclusion, Ehlers-Danlos syndrome presents significant challenges for reconstructive vascular surgery, requiring a careful and individualized approach to optimize outcomes and ensure patient safety. Understanding these relationships is vital for appropriate management and the development of effective surgical protocols.