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[Microsurgical soft tissue reconstruction in lower extremity osteitis].

Susanne Rein1, Juliane Hörnig2, Khosrow Siamak Houschyar3

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Free flap reconstruction for lower extremity osteitis shows similar survival rates for anterolateral thigh (ALT) and latissimus dorsi (LD) flaps. Managing diabetes, acute osteomyelitis, and complications is key for successful outcomes.

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Area of Science:

  • Plastic Surgery
  • Microsurgery
  • Orthopedic Surgery

Background:

  • Septic skin defects from lower extremity osteitis present a reconstructive challenge.
  • Free flap coverage using anterolateral thigh (ALT) or latissimus dorsi (LD) flaps is a common surgical solution.

Purpose of the Study:

  • To retrospectively analyze pre- and intraoperative factors influencing flap loss in free flap reconstruction for lower extremity osteitis.
  • To compare the outcomes of ALT versus LD flaps in this patient population.

Main Methods:

  • Retrospective analysis of 72 patients undergoing free flap reconstruction (27 LD, 45 ALT) between 2004 and 2013.
  • Investigation of anthropometric, pre- and intraoperative parameters to identify factors associated with flap loss.

Main Results:

  • Flap survival rates were comparable: 81.5% for LD and 82.2% for ALT flaps.
  • Major complications significantly increased flap loss for both LD and ALT flaps.
  • Pre-existing diabetes mellitus (LD group) and acute osteomyelitis (ALT group) were associated with higher flap loss.

Conclusions:

  • Successful microsurgical reconstruction for lower extremity osteitis is influenced by managing pre-existing diabetes, acute osteomyelitis, and major complications.
  • Precise microsurgical anastomosis and optimal patient parameter management are crucial for successful plastic reconstruction of soft tissue defects.