Lumbar Perforator Flaps for Coverage of Extensive Defects With Osteomyelitis

Area of Science:

• Reconstructive surgery
• Orthopedic surgery
• Plastic surgery

Background:

• Lumbar osteomyelitis is a serious condition requiring appropriate treatment to prevent complications.
• Traditional treatments favored muscle or myocutaneous flaps for recurrent infections.
• Recent evidence highlights radical debridement and dead space obliteration as crucial.

Purpose of the Study:

• To evaluate the long-term outcomes of using lumbar perforator flaps for lumbar soft tissue defects in patients with chronic osteomyelitis.
• To assess the reliability and effectiveness of lumbar perforator flaps in this specific patient population.

Main Methods:

• Retrospective analysis of 7 consecutive patients (10 flaps) with extensive posterior midline defects (L2-S1).
• Defects resulted from tumor resection, vascular compromise, or debridement of neglected wounds.
• All patients had concomitant bone infection; infectious details and complications were recorded.

Main Results:

• Patients often had significant comorbidities.
• Eight flaps were propeller perforators, two were V-Y perforators; one required revision due to venous congestion.
• Complete healing occurred in 29 ± 17 days; no flap loss was observed with a mean follow-up of 20 months.

Conclusions:

• Lumbar perforator flaps are a dependable choice for reconstructing large lumbar soft tissue defects.
• These flaps demonstrate low donor site morbidity and acceptable cosmetic outcomes, even in the presence of chronic osteomyelitis.