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The Propeller flap for chronic osteomyelitis of the lower extremities: a case report

Rubino, Corrado and Figus, Andrea and Mazzocchi, Marco and Dessy, Luca A. and Martano, A. (2009) The Propeller flap for chronic osteomyelitis of the lower extremities: a case report. Journal of Plastic, Reconstructive & Aesthetic Surgery, Vol. 62 (10), p. e401-e404. ISSN 1748-6815. Article.

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DOI: 10.1016/j.bjps.2007.12.053

Abstract

The goals of the treatment of chronic osteomyelitis are infection eradication with systemic antibiotic therapy and local management with radical excision of the infected tissue and obliteration of the remaining dead space. Adequate debridement and coverage with a well-vascularised tissue are mandatory for successful outcomes. Use of muscle covering for chronic osteomyelitis in the lower extremities is considered the best procedure. However, there have been instances where debridement of the bone tissue did not leave a deep cavity along the leg bones and fasciocutaneous flaps can be used in these instances to cover the defect and to restore function without recurrence of the disease. Recently, free non-muscle flaps have been used and assessed for chronic osteomyelitis or covering of exposed bone. Perforator flaps have been shown to be well vascularised due to a structural haemodynamic enhancement. In the light of these findings we report a successful case of chronic osteomyelitis of the right fibula treated with excision of the affected tissue and covering with a propeller flap. Instead of free flap covering, in order to optimise surgical reconstruction, reducing the operative time, donor and recipient site morbidity and risk of total flap failure, local perforator flaps and particularly the propeller flap may be indicated in the treatment of chronic osteomyelitis in selected patients when the defect is limited and there is no need to fill a deep bone cavity or a dead space. To our knowledge, this the first report of the use of a propeller flap in the treatment of chronic osteomyelitis in the lower extremities.

Item Type:Article
ID Code:3488
Status:Published
Refereed:Yes
Uncontrolled Keywords:Perforator flaps, chronic osteomyelitis, leg ulcers, propeller flap, lower extremities
Subjects:Area 06 - Scienze mediche > MED/19 Chirurgia plastica
Divisions:001 Università di Sassari > 03 Istituti > Dermatologia
Publisher:Elsevier
ISSN:1748-6815
Copyright Holders:© British Association of Plastic, Reconstructive and Aesthetic Surgeons
Deposited On:22 Jan 2010 10:46

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