[An experimental study of the pedicle omental graft with microvascular anastomosis (author's transl)]

The principle of the management of chronic osteomyelitis consists of debridement of sequestra, scar tissues and sinuses, exposing fresh healthy bone and administration of appropriate antibiotics. Here arises the problem: how to eliminate the dead space upon closure of the wound. This paper reports the results or animal experiments on whether pedicle omental graft with microvascular anastomoses can be used to eliminate the dead space of bone. In the first experiment, autogenous omentum with a vascular pedicle was transplanted around the femur of dogs by microvascular anastomoses. Sixteen dogs were operated on and 4, 8, 12, and 20 weeks after the operation, 4 dogs of each stage were anesthetized and anastomosed artery of each was exposed. The contrast medium was injected from this site and then the dog was killed. Specimens from the dogs were histologically examined, and it was proved that the transplanted omentum was alive even 20 weeks after the operation and vascular connection between grafted omentum and the bone and its surrounding tissues had been established. In the second experiment, omentum was transplanted around the frozen necrotized femur of the dog by the same technique. In the control group, the femur of the dog was frozen but omentum was not transplanted. Eight, 12, 20, and 24 weeks after the operation, 3 dogs respectively were labeled by tetracycline and 2 weeks after that, the dogs were killed. Specimens from the femur were studied by fluorescence and light microscopy. As the result, the remodeling of the bone was faster in omental group than in control group. From these two experiments, the following conclusion was drawn. When omentum with vascular pedicle was transplanted around the femur of a dog by vascular anastomoses, it continued to live and makes rich vascular connection with surrounding tissues and as revascularization of necrotic bone accelerated, the remodeling of the bone was promoted. This phenomenon could be applied to the treatment for chronic osteomyelitis.