Clin Osteol 2009; 14(1): 11-14
Free flap transfer and its role in the radical treatment of chronic osteomyelitis of the tibiaReview articles
Chronic osteomyelitis is an inflammatory disease of bones and adjacent soft tissues resulting in impaired perfusion. Radical treatment methods include thorough debridement of both the skeleton and soft tissues and covering the resulting defect with a free flap with in dependent vascular supply. After transfer, the flap has multiple essential roles. It provides enough perfused tissue of good quality to cover the exposed skeletal bone. The flap contains enough tissue to enable further surgical interventions related to the skeleton. In the early postoperative period, systemically administered antibiotics in adequate concentrations are brought to the site as a result of in dependent perfusion. The well-perfused tissue also aids in healing of the bone following radical treatment.
Keywords: Osteomyelitis ofthe tibia, radical treatment, muscle transposition, freeflap, free muscle transfer
Published: June 11, 2009 Show citation
References
- Komatsu S, Tamai S. Successful replantation of a kompletly cut-of tumb. Plast Reconstr Surg 1968;42:374-377.
Go to original source... - Nejedlý A. (Ed) Základy replantační chirurgie. Praha: Grada Publishing, 2003.
- Shaw WW, Hidalgo DA Microsurgery in Trauma. New York: Futura Publishing Comp., 1987.
- Naique SB, Perse M, Nanchahal J. Management of severe open tibial fractures. The need for combinated orthopaedic and plastic surgical treatment in specialist centers. J Bone Joint Surg 2006;88-B:351-357. Go to original source...
- Salvana J, Rodner C, Browner BD, Livingston K, Schreiber J, Pesanti E. Chronic osteomyelitis: Results obtained by an integrated team approach to management. Conn Med 2005;69:195-202.
- Nejedlý A, Džupa V, Tvrdek M. Mezioborová spolupráce plastické a rekonstrukční chirurgie a ortopedie při ošetřování končetinových traumat. Rozhl Chir 2008;87:321-326.
- Nejedlý A, Tvrdek M, Stehlík J. Závěrečná zpráva grantu IGA MZ ČR 1651-3 "Význam užití časných tkáňových přenosů při komplexní léčbě defektních pora nění dolní končetiny". Praha: 3. LF UK 1995
- Pros Z, Tvrdek M, Kletenský J, Nejedlý A, Svoboda, S. Chronic traumatic wounds of the leg. Acta Chir Plast 1996;38:83-86.
- Tvrdek M, Nejedlý A, Kletenský J, Kufa R. Treatment of chronic osteomyelitis of the lower extremity using free flap transfer. Acta Chir Plast 1999;41:46-49.
- Gonzalez MH, Tarandy DI, Troy D, Phillips D, Weinzweig N. Free tissue covera ge of chronic traumatic wounds of the lower leg. Plast Reconstr Surg 2002;109:592-600. Go to original source...
- Kuokkanen HO, Tukiainen EJ, Asko-Seljavaara S. Radical excision and recon struction of chronic tibial osteomyelitis with microvascular muscle flaps. Orthopaedics 2002;25:137-140. Go to original source...
- Kutscha-Lissberg F, Hebler U, Kälicke T, Arens S. Principen chirurgischen Therapiekonzepte der postoperativen und chronischen Osteomyelitis. Orthopäde 2004;33:439-454. Go to original source...
- Nejedlý A, Džupa V, Záhorka J, Tvrdek M. Využití muskulárního laloku při léčení infikovaných zlomenin a chronické osteomyelitidy v oblasti bérce a hlezna. Acta Chir Orthop Traumatol Cech 2007;74:162-170 Go to original source...
- Orr HW: The treatment of acute osteomyelitis by drainage and rest. J Bone Jt Surg, 9:733-739, 1927.