The 1st photo on the left shows a preoperative image of the dorsal right arm with hemorrhagic bullae and cyanotic skin lesions. The 2nd photo from the left shows erupted vesicles on the medial arm. The 3rd and 4th photos show postoperative changes with extensive skin necrosis on the dorsal side and myonecrosis and cyanotic changes of underlying flexor muscles on the medial aspect.