“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”

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.