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A novel approach in surgical management of chronic and recurrent olecranon bursitis
Brian H. Gander, MD
Guy Stofman, MD
University of Pittsburgh Medcial Center
2015-03-15
Presenter: Brian H. Gander, MD
Affidavit:
yes
Director Name: Joseph E. Losee, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Hand
Introduction
Chronic olecranon bursitis is a condition that affection 10/100,000, the majority of which are males, with a high recurrence rate. Traditionally local or regional flaps have been utilized in closure of these complex wounds. We present three successful cases of a "pants-over-vest" technique that uses the excess skin over the olecranon to obliterate the dead space and close the wound without sacrificing potential future flap of reconstruction.
Methods
Two patients presented to a single surgeon with chronic or recurrent aseptic olecranon bursitis.In all three patients a longitudinal incision was made over the olecranon and cutaneous flaps were created. Following the removal of bursal tissue the medially based dermal flap was de-epithelialized then buried and anchored laterally underneath the lateral dermal flap. The lateral dermal flap was then advanced medially over the de-epithealized flap and sutured to healthy medial tissue.
Results
During the three month follow-up period there were no recurrences of the previously treated bursitis. There were no reported wound dehiscences and closed suction drains that were placed during surgery were removed 1-2 weeks at follow-up appointments.
Conclusions
Recurrent and chronic olecranon bursitis is a difficult condition to treat and traditional use of local or regional flaps have been used to manage this condition. We present a novel method that was successfully used to treat two such patients with this condition. Our "pants-over-vest" method obliterates the dead space, closes the wound and preserves future reconstructive options which is exceedingly important given the recurrent nature of this process.
