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Related Experiment Video

Updated: Jun 27, 2026

A Model of Free Tissue Transfer: The Rat Epigastric Free Flap
10:10

A Model of Free Tissue Transfer: The Rat Epigastric Free Flap

Published on: January 15, 2017

Principles of definitive soft tissue coverage with flaps.

L Scott Levin1

  • 1Division of Orthopaedic Surgery and the Division of Plastic and Reconstructive Surgery, Duke University Medical Center, Durham, NC, USA. levin001@mc.duke.edu

Journal of Orthopaedic Trauma
|December 17, 2008
PubMed
Summary

Negative pressure wound therapy with reticulated open cell foam (NPWT/ROCF) aids orthopaedic trauma reconstruction. However, microsurgical flaps remain the definitive solution for soft tissue coverage, despite NPWT/ROCF

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Area of Science:

  • Orthopaedic Surgery
  • Plastic Surgery
  • Wound Healing

Background:

  • Microsurgical tissue transfer is the standard for soft tissue reconstruction in orthopaedic traumatology.
  • Criticisms include procedure length, cost, and required technical expertise.
  • Access to skilled microsurgeons remains a challenge.

Purpose of the Study:

  • To evaluate the role of Negative Pressure Wound Therapy with Reticulated Open Cell Foam (NPWT/ROCF) in orthopaedic soft tissue reconstruction.
  • To compare NPWT/ROCF with traditional microsurgical flap procedures.
  • To address the deficit of flap surgeons in orthopaedic traumatology.

Main Methods:

  • Review of current literature on NPWT/ROCF and microsurgical flap techniques.
  • Analysis of outcomes in orthopaedic trauma cases requiring soft tissue coverage.

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  • Discussion of the evolving landscape of wound healing technologies.

    • Main Results:

    • NPWT/ROCF is a valuable adjunct, often serving as a temporary measure or 'bridge' to definitive reconstruction.
    • Microsurgical procedures, while demanding, achieve high success rates when performed by experienced surgeons.
    • Advancements in flap technology, including perforator and local regional flaps like the sural flap, continue to enhance reconstructive options.

    Conclusions:

    • Microsurgical flaps remain the gold standard for definitive soft tissue reconstruction in orthopaedic trauma.
    • NPWT/ROCF is a useful tool but not a replacement for skilled flap surgery.
    • Continued advancements in both flap techniques and wound healing technologies are crucial for optimal patient outcomes.