Free intra-osseous muscle transfer for treatment of chronic osteomyelitis

Thua, Trung-Hau Lê; Boeckx, W.; Zirak, Christophe; Mey, Albert De

doi:10.3109/2000656x.2015.1049952

Cited by 6 publications

(5 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of the 260 muscle flaps where total flap loss rates were discussed, 27 flaps or 10.4% experienced total flap loss. 9,[11][12][13][14][15]17,21,23,24,27,29 Two fasciocutaneous flap studies reported total flap loss totaling to 5.3% (n ¼ 1). 9,23 Both of the grouped fasciocutaneous and muscle flap studies reported total flap loss amounting to 6 of the 127 flaps, or 4.7%.…”

Section: Total Flap Lossmentioning

confidence: 99%

See 1 more Smart Citation

Choosing between Muscle and Fasciocutaneous Free Flap Reconstruction in the Treatment of Lower Extremity Osteomyelitis: Available Evidence for a Function-Specific Approach

Kovar

Colakoğlu

Iorio

2019

J reconstr Microsurg

View full text Add to dashboard Cite

Background Limb salvage in the setting of extremity osteomyelitis, though previously dependent on amputation, has been markedly improved through the application of free tissue flaps. Concern exists as to the utility of the fasciocutaneous flap to combat infection verses the traditional muscle flap. Prior studies have shown success with fasciocutaneous flaps in these patients, but given the small series, the choice remains controversial. The goal of this article was to determine if there is statistical evidence for flap choice in the setting of extremity osteomyelitis. Methods A systematic review utilizing Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was completed of the current literature pertaining to the treatment of extremity osteomyelitis and flap reconstruction within the MedLine and PubMed databases. Six hundred forty-six studies were reviewed and ultimately 31 were included in the final analysis. Results Eight hundred seventy-eight flap reconstructions were identified. Of the 588 muscle flaps, 7.8% (n = 46) had recurrence of osteomyelitis after an average of 36.1 (8.0–111.6) months follow-up. There were seven cases (4.3%) of osteomyelitis recurrence in the 163 fasciocutaneous flap group after an average of 29.8 (18.2–44.6) months follow-up (p = 0.165). Secondary outcomes such as flap loss, hematomas, and infection were analyzed without statistically significant differences between the muscle and fasciocutaneous flap groups. Conclusion Selection of flap type is less important than adequate debridement, appropriate antibiotic selection, and sufficient duration of treatment. This study demonstrates that within the literature, fasciocutaneous flaps have a lower recurrence rate of osteomyelitis compared with muscle flaps. As such, fasciocutaneous flaps are appropriate for reconstruction and treatment of extremity osteomyelitis.

show abstract

Section: Total Flap Lossmentioning

confidence: 99%

“…About 7.8% of muscle flaps in these pooled studies experienced partial flap loss (n ¼ 16 of 205). 1,11,[13][14][15]23,24,26 Two fasciocutaneous flap studies reported partial flap loss totaling to 3.6% (n ¼ 1 of 28). 23,33 This was not a statistically significant difference in outcomes between the two groups (p ¼ 0.701).…”

Section: Partial Flap Lossmentioning

confidence: 99%

Choosing between Muscle and Fasciocutaneous Free Flap Reconstruction in the Treatment of Lower Extremity Osteomyelitis: Available Evidence for a Function-Specific Approach

Kovar

Colakoğlu

Iorio

2019

J reconstr Microsurg

View full text Add to dashboard Cite

show abstract

“…However, the radical debridement itself creates a dead space in the depth of the wound, which may cause spread of infection and resultant loss of larger tissues if not filled adequately. The muscular flap is considered a stronger anti‐infective, vascularized tissue than other flaps like the de‐epithelialized skin flap because it has robust blood supply 45,46–51 . With the aim of dissecting the DIEA towards the distal end and including as many muscular branches as possible, the rectus muscle mass in our chimeric DIEP flap served well as no infection was found in our case series.…”

Section: Discussionmentioning

confidence: 77%

Novel Design of the Chimeric Deep Inferior Epigastric Artery Perforator Flap that Provides for Three‐Dimensional Reconstruction of Composite Tissue Defects of the Heel in Children

Luo

2021

Orthopaedic Surgery

View full text Add to dashboard Cite

Objective The aim of the present study was to report a novel design of the chimeric deep inferior epigastric artery perforator flap (DIEP) to achieve dead space filling, Achilles tendon bridging, and skin resurfacing simultaneously with minimal donor‐site morbidity. Methods From September 2012 to May 2016, a retrospective study was carried out on six pediatric patients with composite soft tissue defects of the heel that were repaired with the chimeric DIEP flap. The chimeric flap design included a flap of the anterior sheath of the rectus, a block of rectus muscle, and a large skin paddle. All the parts were supplied by a common artery. After harvesting the flap, all element parts were inserted at the corresponding sites in a tension‐free manner. With one set of vessel anastomoses at the recipient site, accurate repair with tendon reconstruction, dead space elimination, and wound covering were accomplished. The donor site incisions were closed initially. Data on patient age, medical history, injury severity, defect size, flap dimensions, recipient vessels, donor site closure, complications, and follow‐up were collected and reviewed. Results Five of the six chimeric DIEP flaps survived without complications. The remaining one case experienced partial necrosis of the skin paddle caused by venous congestion, which healed after routine dressing changes. Primary donor site closure was accomplished in all cases. The mean follow‐up was 18.6 months (range, 10–36 months). Five patients had satisfactory aesthetic and functional outcomes; one patient needed a secondary debulking procedure. Compared to the unaffected side, the affected side showed no obvious difference for ankle movement, tiptoe function, and patient gait during the follow‐up period. Good ankle function was observed in all patients. There was no donor site breakdown, with only a slightly noticeable linear scar. Conclusion The chimeric DIEP flap reduced the operative time, solved the problem of deficiency of recipient vessels, and attained satisfactory functional and aesthetic outcomes with low donor site morbidity. Therefore, it is a promising option for three‐dimensional reconstruction of composite defects with dead space and Achilles tendon defects as well as skin loss in children.

show abstract

“…Osteomyelitis is generally highly dependent on the degree of damage to the soft tissue envelope 1) ; therefore, replacement of the surrounding tissue may be required. Many previous reports have demonstrated the versatility of muscular or fascial flaps for osteomyelitis of the long bones or bones of the trunk [2][3][4][5] ; however, few have described such efforts in cases involving digital bones. According to previous reports, the cure rates of osteomyelitis are comparable between muscular and fascial flaps, and fascial or fasciocutaneous flaps have advantages in terms of aesthetic results and donor-site morbidity [6][7][8] .…”

Section: Discussionmentioning

confidence: 99%

Intrinsic Adipofascial Flaps Aiming Infection Control of Purulent Arthritis or Osteomyelitis in a Digit

Minagawa

2024

International Journal of Surgical Wound Care

View full text Add to dashboard Cite

Managing infections of bony structures in the digit, especially in cases where the overlying soft tissue is damaged or the patient is immunocompromised, remains challenging. Although many reports have documented the efficacy of muscular and fascial flaps, few local flaps are available for affected hands. We herein report two complicated cases of purulent arthritis or osteomyelitis occurring in the interphalangeal joint of the hand. The patient underwent intrinsic adipofascial flap transfer to the actively affected joints, subsequently achieving prompt infection control and finally achieving functional and aesthetic healing of the hands. Clinical results suggest that intrinsic adipofascial flaps are extremely effective in controlling active infections of deep tissue in digits with few donor-site morbidities.

show abstract

Free intra-osseous muscle transfer for treatment of chronic osteomyelitis

Cited by 6 publications

References 16 publications

Choosing between Muscle and Fasciocutaneous Free Flap Reconstruction in the Treatment of Lower Extremity Osteomyelitis: Available Evidence for a Function-Specific Approach

Choosing between Muscle and Fasciocutaneous Free Flap Reconstruction in the Treatment of Lower Extremity Osteomyelitis: Available Evidence for a Function-Specific Approach

Novel Design of the Chimeric Deep Inferior Epigastric Artery Perforator Flap that Provides for Three‐Dimensional Reconstruction of Composite Tissue Defects of the Heel in Children

Intrinsic Adipofascial Flaps Aiming Infection Control of Purulent Arthritis or Osteomyelitis in a Digit

Contact Info

Product

Resources

About