Treatment of chronictibial osteomyelitis with irrigation sequential Flow-through type anterolateral thigh chimeric myocutaneous flap / 中华显微外科杂志

ABSTRACT

Objective To investigate the clinical effects of irrigation sequential Flow-through type anterolat eral thigh chimeric myocutaneous flap in the treatment of chronic tibial osteomyelitis.Methods From January,2012 to December,2017,trench grooved sequential Flow-through anterolateral femoral chimeric flaps were u sed to treat chronic tibial osteomyelitis.On the basis of sensitive antibiotics,bone grooving and VSD grooved sequential Flow-through anterolateral thigh chimeric flaps were used to fill the bone cavity and cover the wound.The patients received the follow-up care in outpatient office and telephone regularly after hospital discharge.Results Among the 18 cases in this group,2 cases were positive and 16 cases were negative in secondary bacteriological detection.The flaps and donor sites survived in one stage.Fifteen cases healed in one stage,and extravasate occurred in 3 cases after operation.After dressing change,the wounds healed in 25 days,32 days and 43 days after flap operation,respectively.All the patients were followed-up for 12 to 30 months,with an average of 25 months.Local low toxicity infection symptom occurred again in 1 case with delayed healing 6 months after operation.After 1 week of antibiotic treatment,the symptom subsided.After 1 more week of antibiotic use,the patient was discharged from hospital.And followed-up for 1 year,no recurrence occurred.During the follow-up period,no recurrence of infection and no fracture occurred after primary fracture healing in other 17 cases.One year after the second operation,there was no obvi ous stenosis in the bridged vessels examined by Doppler ultrasonography and the blood flow velocity was the same as that of the contralateral limbs.Conclusion The application of irrigation and sequential Flow-through type anterolateral thigh chimeric myocutaneous flap for treatment of chronic tibial osteomyelitis can achieve good therapeutic effect and is worth popularizing.