A Retrospective Comparative Study between Muscle Flaps and Fasciocutaneous Flaps in Reconstruction of Chronic Osteomyelitis Related Wounds of the Lower Limb in the Adult Population

Document Type : Original Article

Authors

1 The Department of Plastic Surgery, Faculty of Medicine, Mansoura University

2 The Department of Orthopedic Surgery, Faculty of Medicine, Mansoura University

Abstract

Introduction: Chronic osteomyelitis cases are challenging,
as they require a multidisciplinary approach for reconstructive
soft tissue coverage and orthopedic management. Proper
debridement, stable coverage and effective antibiotic therapy
are mandatory before application of flap coverage.
Patients and Methods: We performed a retrospective
comparative study between muscle and fasciocutaneous flaps
used for coverage of chronic osteomyelitis related wounds of
the lower limb. It included thirty patients who finished a 12
months of follow-up to assess the complications rate and the
outcome of surgery. Color match, texture match and aesthetic
satisfaction were compared between the 2 groups.
Results: Thirty-one flaps including six free flaps and
twenty-five local flaps were used to treat these cases. Complications
included fluid collections in one case, sinus formation
in two 2 cases, partial flap loss in one case. These
complications were managed by prolonged antibiotic therapy
and dressing changes. Cases in group B had higher scores
(mean: 9.5±1.34) in comparison with cases in group A (mean:
7.25±1.29). Yet, there were no statistically significant differences
between the 2 groups (p-value: 0.27).
Conclusion: A multidisciplinary team is needed for management
of cases with chronic osteomyelitis related wounds.
Flap coverage can be achieved with either muscular or fasciocutaneous
flaps with comparable successful rates.

Keywords

Main Subjects


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