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DOI: 10.1055/s-2006-931906
Free Fasciocutaneous Flaps in the Treatment of Chronic Osteomyelitis of the Tibia: A Retrospective Study
Publication History
Accepted: September 20, 2005
Publication Date:
19 January 2006 (online)
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ABSTRACT
The efficacy of free fasciocutaneous flaps for the treatment of chronic osteomyelitis of the tibia was evaluated in a retrospective study. A series of 14 patients is reported who underwent soft-tissue reconstruction using different free fasciocutaneous flaps after radical debridement. Radical debridement and microvascular reconstruction were performed in two operative steps. The mean duration of disease was 14 years (range: 6 months to 37 years). At a mean follow-up of 31.4 (12 to 52) months, there was no evidence of recurrence of osteomyelitis.
This retrospective study validates that fasciocutaneous flaps can be used for microsurgical soft-tissue reconstruction after radical debridement in the treatment of chronic osteomyelitis. The introduction of free fasciocutaneous flaps has challenged the dictum of the therapy of chronic osteomyelitis with muscle flaps.
KEYWORDS
Free fasciocutaneous flaps - chronic osteomyelitis - tibia
REFERENCES
- 1 Mathes S J. The muscle flap for management of osteomyelitis. N Engl J Med. 1982; 306 294-295
- 2 Mathes S J, Feng L J, Hunt T K. Coverage of the infected wound. Ann Surg. 1983; 198 420-429
- 3 Musharafieh R, Osmani O. Efficacy of microsurgical free-tissue transfer in chronic osteomyelitis of the leg and foot: review of 22 cases. J Reconstr Microsurg. 1999; 5 239-244
- 4 Mathes S J, Alpert B S, Chang N. Use of the muscle flap in chronic osteomyelitis: experimental and clinical correlation. Plast Reconstr Surg. 1982; 69 815-829
- 5 Arnold P G, Yugueros P, Hanssen A D. Muscle flap in osteomyelitis of the lower extremity: a 20-year account. Plast Reconstr Surg. 1999; 104 107-110
- 6 May Jr J W, Rohrich R J. Foot reconstruction using free microvascular muscle flaps with skin grafts. Clin Plast Surg. 1986; 13 681-689
- 7 Arnold P G, Yugueros P, Hanssen A D. Muscle flap in osteomyelitis of the lower extremity: a 20-year account. Plast Reconstr Surg. 1999; 104 107-110
- 8 Gosain A, Chang N, Mathes S. A study of the relationship between blood flow and bacterial innoculation in musculocutaneous and fasciocutaneous flaps. Plast Reconstr Surg. 1990; 86 1158-1162
- 9 Mathes S J. The muscle flap for management of osteomyelitis. N Engl J Med. 1982; 306 294-295
- 10 Gosain A, Chang N, Mathes S. A study of the relationship between blood flow and bacterial innoculation in musculocutaneous and fasciocutaneous flaps. Plast Reconstr Surg. 1990; 86 1158-1162
- 11 Gottrup F, Firmin R, Hunt T K, Mathes S J. The dynamic properties of tissue oxygen in healing flaps. Surgery. 1984; 95 527-536
- 12 Chang N, Mathes S J. Comparison of the effect of bacterial inoculation in musculocutaneous and random-pattern flaps. Plast Reconstr Surg. 1982; 70 1-10
- 13 Eshima I, Mathes S J, Paty P. Comparison of the intracellular bacterial killing activity of the leukocytes in musculocutaneous and random-pattern flaps. Plast Reconstr Surg. 1990; 86 541-547
- 14 Calderon W, Chang N, Mathes J. Comparison of the effect of bacterial inoculation of musculocutaneous and fasciocutaneous flaps. Plast Reconstr Surg. 1986; 77 785-792
- 15 May Jr J W, Rohrich R J. Foot reconstruction using free microvascular muscle flaps with skin grafts. Clin Plast Surg. 1986; 13 681-689
- 16 Zumiotti A V, Wei Teng H, Ferreira M C. Treatment of post-traumatic tibial osteomyelitis using microsurgical flaps. J Reconstr Microsurg. 2003; 19 163-171
- 17 Musharafieh R, Osmani O. Efficacy of microsurgical free-tissue transfer in chronic osteomyelitis of the leg and foot: review of 22 cases. J Reconstr Microsurg. 1999; 5 239-244
- 18 Fix J R, Vasconez L O. Fasciocutaneous flaps in reconstruction of the lower extremity. Clin Plast Surg. 1991; 18 571-581
- 19 Urbaniack J R, Koman A L, Goldner R D. The vascularized cutaneous scapular flap. Plast Reconstr Surg. 1982; 69 772-778
- 20 Baumeister R G, Frick A. Myocutaneous and fasciocutaneous free flap for covering the lower leg and foot. Langenbecks Arch Chir Suppl Kongressbd. 1991; 587-592
- 21 Gordon L, Chiu E J. Treatment of infected non-unions and segmental defects of the tibia with staged microvascular muscle transplantation and bone grafting. J Bone Joint Surg Am. 1988; 70 377-386
- 22 Anthony J P, Mathes S J, Alpert B S. The muscle flap in the treatment of chronic lower extremity osteomyelitis: results in patients over 5 years after treatment. Plast Reconstr Surg. 1991; 88 311-318
- 23 Gallie W E. First recurrence of osteomyelitis eighty years after infection. J Bone Joint Surg Br. 1951; 33 110-111
- 24 Anthony J P, Mathes S J, Alpert B S. The muscle flap in the treatment of chronic lower extremity osteomyelitis: results in patients over 5 years after treatment. Plast Reconstr Surg. 1991; 88 311-318
Mirjam Zweifel-SchlatterM.D.
Department of Plastic and Reconstructive Surgery, University Hospital of Basel
Spitalstr. 21, CH-4031 Basel, Switzerland
Email: mzweifel@uhbs.ch