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Fasciocutaneous Free Flaps in the Setting of Chronic Osteomyelitis: Safety of Re-Elevation
Farrah Liu, B.S., Erica Y. Xue, M.S., Paul J. Therattil, M.D., Haripriya Ayyala, M.D., Edward S. Lee, M.D., Jonathan D. Keith, M.D..
Rutgers New Jersey Medical School
2018-02-07
Presenter: Farrah C. Liu, B.S.
Affidavit:
The material proposed for presentation in this abstract is original and has not been published in a scientific journal or presented at a major meeting.
Director Name: Edward S. Lee
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
BACKGROUND: Free flap-based reconstruction in the setting of chronic osteomyelitis can be a complex, multi-stage process requiring elevation of the free flap at each stage. Use of fasciocutaneous flaps is a safe and effect option in this situation, and may actually be preferable to muscle or musculocutaneous flaps despite traditional recommendations. Here the authors present their experience in utilizing fasciocutaneous flaps for reconstruction of the lower extremity in the setting of chronic osteomyelitis.
METHODS: A retrospective review of a single-center's experience with lower extremity free flap reconstruction in the setting of chronic osteomyelitis was performed. Charts were reviewed for relevant risk factors, operative details, and outcomes.
RESULTS: Seven patients underwent reconstruction with a total of 7 free anterolateral thigh fasciocutaneous flaps. Mean patient age in our series was 61 years. Mean BMI at time of reconstruction was 29.6 kg/m2. The average defect size was 171 cm2. Patients required a mean of 2.5 debridements prior to flap reconstruction and 4.75 surgeries to complete the reconstructive process. The mean time from initial injury to final surgery was 149 days. Mean follow-up time period was 6 months. There were no major complications, urgent returns to the operating room, or flap losses.
CONCLUSIONS: Use of fasciocutaneous flaps in lower extremity reconstruction in the setting of chronic osteomyelitis appears to be safe and effective. Despite the need to raise the flaps multiple times, there were no issues in our series with regard to partial or total flap loss, or breakdown resulting in hardware exposure.
