TY - JOUR T1 - Muscular Versus Non-Muscular Free Flaps for Soft Tissue Coverage of Chronic Tibial Osteomyelitis TT - JF - World-J-Plast-Surg JO - World-J-Plast-Surg VL - 7 IS - 3 UR - http://wjps.ir/article-1-450-en.html Y1 - 2018 SP - 294 EP - 300 KW - Inferior limb KW - Chronic osteomyelitis KW - Free flap KW - Reconstructive surgery KW - Microsurgery N2 - 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. M3 10.29252/wjps.7.3.294 ER -