Article
Microsurgical Approach to the Management of Chronic Osteomyelitis
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Published: | February 6, 2020 |
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Objectives/Interrogation: In this study, Microsurgical approach was utilized to manage chronic osteomyelitis in different parts of limbs, and optimal procedure and therapeudic effects were described and discussed.
Methods: During this treatment strategy, local blood supply of the infected skeletal tissues was taken into serious consideration before operation. Necrotic and infected skeletal tissues were debrided. Muscle flap or musculocutaneous flap were transferred to dead space to improve local blood supply. When no suitable muscle flap could be transferred from adjacent area, antibiotic bone cement blocks were filled in the dead space with following skin flap covering. They could provide a highly vascularized soft tissue bed, which can then be utilized as a future graft repository. Finally multiple modalities were successfully utilized to graft into the soft tissue bed. These measures included the use of autogenous cancellous bone graft, bone graft with vascular pedicle, bone graft with vascular anastomosis, and distraction osteogenesis bone transport techniques. In this study, 89 cases were treated with this approach.
Results and Conclusions: Chronic osteomyelitis of all cases have been successfully treated with this microsurgical approach in this study. With an advantage of improving local blood supply, microsurgical approach has unique superiority to treat chronic osteomyelitis.