Clinical effect of free chimeric anterolateral thigh flap and chimeric thoracodorsal artery perforator flap in chronic osteomyelitis

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BackgroundChronic osteomyelitis poses a formidable challenge for orthopedic practitioners in the realm of clinical practice. Chimeric perforator flap is a commonly used repair method for chronic osteomyelitis. The purpose of this study was to compare the clinical efficacy of chimeric anterolateral thigh flap (C-ALTP) and chimeric thoracodorsal artery perforator flap (C-TDAP) for the treatment of chronic osteomyelitis. MethodsA retrospective analysis was performed on patients with chronic osteomyelitis of the lower extremity who underwent two kinds of treatment with chimeric perforator flaps from January 2014 to March 2022. The preoperative basic data, the operative and postoperative basic information of the two groups were collected and statistically analyzed. ResultsSixty-six patients were included in this study, and both groups achieved good aesthetic and functional results. Intraoperative results showed that the intraoperative blood loss and flap acquisition time in the C-TDAP group were less than those in the C-ALTP group. The incidence of postoperative complications in the donor and recipient sites in the C-TDAP group was significantly lower than that in the C-ALTP group, which led to a high reoperation rate in the C-ALTP group. Long-term follow-up showed that the wound healing time and weight-bearing walking time in the C-TDAP group were less than those in the C-ALTP group. ConclusionsBoth chimeric perforator flaps can effectively treat osteomyelitis with composite tissue defects, effectively eliminate inflammation of affected limbs and promote wound healing. However, C-TDAP flaps have more reliable healing effects on wounds and donor sites, and have fewer complications. Level of evidenceIII, Case–control study.