Free vascularized bone and muscle flaps for osteomyelitis

Chronic, post-traumatic osteomyelitis remains an unsolved problem for orthopedists. With improved knowledge of skin and muscle flap circulation, surgeons are now capable of covering wide defects left by debridement. Early clinical experience with muscle and skin flaps to improve vascularity and achieve a stable, closed wound have been encouraging. Management of wounds with infected bone is primarily aimed at resection of infected or nonviable tissue. Antibiotics are of value, however are of secondary importance to a thorough debridement. It is uncertain as to whether osteomyelitis is a curable entity. However, free tissue transfer affords the surgeon the opportunity to perform a thorough debridement and achieve a stable closed wound.