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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.

Ohio,Pennsylvania,West Virginia,Indiana,Kentucky,Pennsylvania American Society of Plastic Surgeons

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