Muscle versus Nonmuscle Flaps in the Reconstruction of Chronic Osteomyelitis Defects

Salgado, Christopher J.; Mardini, Samir; Jamali, Amir A.; Ortiz, Juan A.; Gonzales, Raoul; Chen, Hung-Chi

doi:10.1097/01.prs.0000239579.37760.92

Cited by 94 publications

(57 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several recent articles have demonstrated equivalence in healing or clearance of infection for fasciocutaneous and muscle flaps, which was consistent with the findings of our study. [7][8][9][10] Both fasciocutaneous and muscle flaps provide vascularized tissue, which protects and nourishes the fractured bone Lower Limb Salvage: Perforator Flaps versus Muscle Flaps but muscle flaps pilfer a full muscle unit which may not be inconsequential in a patient trauma. In addition to preserving motor units, we have found that perforator skin flaps are easier than muscle flaps to elevate when delayed bone grafting or fixation is required as they do not form a dense-fibrotic scar to the underlying bone and soft tissue.…”

Section: Discussionmentioning

confidence: 98%

Functional Outcomes of Posttraumatic Lower Limb Salvage: A Pilot Study of Anterolateral Thigh Perforator Flaps Versus Muscle Flaps

Rodriguez

Bluebond-Langner

Copeland

et al. 2009

Journal of Trauma: Injury, Infection &Amp; Critical Care

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 98%

Functional Outcomes of Posttraumatic Lower Limb Salvage: A Pilot Study of Anterolateral Thigh Perforator Flaps Versus Muscle Flaps

Rodriguez

Bluebond-Langner

Copeland

et al. 2009

Journal of Trauma: Injury, Infection &Amp; Critical Care

View full text Add to dashboard Cite

show abstract

“…6 Despite recent reports showing no differences in outcome for the use of fasciocutaneous versus muscle flaps, 7 large cavities require transfer of well perfused, voluminous tissue, which fasciocutaneous flaps often lack.…”

Section: Discussionmentioning

confidence: 98%

Ischial pressure sores: Reconstruction using the perforator‐based reverse flow musculocutaneous 180° propeller flap

Jakubietz

et al. 2009

Microsurgery

View full text Add to dashboard Cite

The treatment of pressure sores requires soft tissue reconstruction with thick tissue to provide padding of bony prominences and obliterate dead space. Fasciocutaneous flaps may not provide adequate bulk. Propeller flaps (180 degrees) based on perforators from the gluteal artery may be harvested as a reverse flow musculocutaneous flap including a muscle plug to reconstruct deep cavities. Three patients presenting with deep pressure sores required reconstruction of large cavities. In addition to a regular 180 degrees propeller flap, a muscle plug based on a perforator found in the blade of the propeller was used to add bulk to the flap and obliterate the cavity with well-vascularized tissue. One flap required secondary closure of the donor site due to dehiscence, one hematoma required drainage. All flaps survived completely. No recurrence of osteomyelitis or pressure sores was seen. The 180 degrees propeller flap can be harvested as a reverse flow musculocutaneous flap including a muscle plug in the distal blade. This adds volume which is required to adequately obliterate large cavities in cases of osteomyelitis. This new technique may be useful in other areas as well.

show abstract

“…No study has demonstrated that 4 to 6 weeks of antibiotics can be more effective [10, 27]. Salgado reported the use of muscle versus non-muscle flaps for the treatment of chronic tibia osteomyelitis in animals, antibiotics for 5 days postoperatively, and no recurrence of infection within 1-year follow-up [28]. Knopp [29] reported 47 cases of chronic osteomyelitis, and intravenous antibiotics were administered for 3 to 5 days with an infection control rate of 85%.…”

Section: Discussionmentioning

confidence: 99%

“…Muscle flap to fill the cavity is often applied, but it may affect the aesthetic and limit the function of donor site [28, 32]. Complications for treating hematogenous osteomyelitis include myositis, soft tissue abscess, fasciitis or blood borne complications, such as DVT [20].…”

Section: Discussionmentioning

confidence: 99%

Induced membrane technique for the treatment of chronic hematogenous tibia osteomyelitis

Wang

et al. 2017

BMC Musculoskelet Disord

View full text Add to dashboard Cite

BackgroundChronic hematogenous osteomyelitis often results from the improper treatment of acute hematogenous osteomyelitis. At present, there is lack of uniform standards for the treatment, and the clinical features of the disease are unclear. The purpose of this study was to explore the clinical efficacy and complications of chronic hematogenous tibia osteomyelitis treated with the induced membrane technique.MethodsA retrospective analysis of the chronic hematogenous tibia osteomyelitis patients in our department admitted from January 2013 to February 2014 and treated with the induced membrane two-stage surgical technique was performed. The defects were filled with antibiotic-loaded polymethyl methacrylate (PMMA) cement after radical debridement, and bone grafts were implanted to repair the defects after 6 to 8 weeks.ResultsA total of 15 cases were admitted in this study, including 13 men and 2 women with a mean age of 34 years (6 to 51). The mean duration of bone infection was 142 months (3 to 361). All patients were cured with an average follow-up of 25 months (24 to 28). Radiographic bone union occurred in 5.3 months (3 to 8), and full weight bearing occurred in 6.7 months (4 to 10). No recurrence of infection was noted at the last follow-up. Two cases required repeated debridement before grafting due to recurrent infection. One patient had a small bone diameter due to insufficient grafting, and one patient had limitation of knee activity.ConclusionsThe induced membrane technique for the treatment of chronic hematogenous tibia osteomyelitis is an effective and reliable method. Thorough debridement and wound closure at the first stage is essential for infection control as well as sufficient grafting at the second stage to ensure bone union.

show abstract

Muscle versus Nonmuscle Flaps in the Reconstruction of Chronic Osteomyelitis Defects

Abstract: The findings in this study demonstrate that vascularized tissue flaps in the form of muscle or nonmuscle flaps provide viable options for wound coverage of osteomyelitis defects following adequate surgical debridement.

Cited by 94 publications

References 21 publications

Functional Outcomes of Posttraumatic Lower Limb Salvage: A Pilot Study of Anterolateral Thigh Perforator Flaps Versus Muscle Flaps

Functional Outcomes of Posttraumatic Lower Limb Salvage: A Pilot Study of Anterolateral Thigh Perforator Flaps Versus Muscle Flaps

Ischial pressure sores: Reconstruction using the perforator‐based reverse flow musculocutaneous 180° propeller flap

Induced membrane technique for the treatment of chronic hematogenous tibia osteomyelitis

Contact Info

Product

Resources

About