Volume 7, Issue 3 (7-2018)                   wjps 2018, 7(3): 294-300 | Back to browse issues page


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Buono P, Castus P, Dubois-Ferrière V, Rüegg E M, Uçkay I, Assal M, et al . Muscular Versus Non-Muscular Free Flaps for Soft Tissue Coverage of Chronic Tibial Osteomyelitis. wjps. 2018; 7 (3) :294-300
URL: http://wjps.ir/article-1-450-en.html
Department of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals, Faculty of Medicine, University of Geneva, Switzerland
Abstract:   (1304 Views)
BACKGROUND
Eradication of chronic tibial osteomyelitis necessitates aggressive debridement often followed by soft tissue reconstruction. Muscular flaps are said to be more effective than non-muscular flaps for infection treatment, while fasciocutaneous and perforator flaps are considered being less invasive and offering a better aesthetic result.
METHODS
In this study we reviewed 24 consecutive cases of chronic tibial osteomyelitis treated according to a specific protocol in a tertiary hospital. Soft tissue coverage was done with either muscular or non-muscular free flaps. Infection recurrence and complications were compared between different flap types. Additionally, we assessed the long-term functional and aesthetic results and patient’s satisfaction.
RESULTS
Muscular flap was used in 13 patients (13 latissimus dorsi and 1 serratus anterior) and 11 patients underwent fasciocutaneous / perforator flaps (1 anterolateral thigh flap, 4 lateral arm flaps, 5 thoracodorsal artery perforator (TAP) flaps and 1 radial forearm flap).
Infection was resolved for 84.6% of patients in the muscular flaps group and 90.9% in the non-muscular flaps group. None of the patients with muscular flaps were satisfied with the aesthetic appearance of their reconstructed leg compared to 83.3% of patients with non-muscular flaps. Also a slight regain of touch sensitivity was acknowledged in the non- muscular flap group compared to the muscular.
CONCLUSION
In this study of adult chronic tibial osteomyelitis cases, we demonstrated that fasciocutaneous and perforator free flaps offer a comparable efficacy to the muscle flaps for infection treatment, with a significantly higher patient satisfaction and aesthetic result.
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Type of Study: Original Article | Subject: Special
Received: 2018/10/12 | Accepted: 2018/10/12 | Published: 2018/10/12

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