Use of the Keystone Perforator Island Flap in the treatment of chronic lower extremity wounds complicated by osteomyelitis
- Resource Type
- Authors
- Bence Baljer; Giuseppe Sanese; Federico Lo Torto; Valerio Cervelli; Fabio Nicoli; Agostino Perra; Ahmed Al-Mousawi; Omar Hausien
- Source
- Injury. 51:744-749
- Subject
- Adult
Male
medicine.medical_specialty
Soft Tissue Injuries
Bone infection
Chronic wounds
Keystone flap
Local flap
Lower extremity
Lower limb reconstruction
Orthoplastic
Osteomyelitis
Perforator flap
Reconstruction
Soft tissue
medicine.medical_treatment
Bone Infection
03 medical and health sciences
0302 clinical medicine
medicine
Humans
Reconstructive Surgical Procedures
Aged
General Environmental Science
Leg
Wound Healing
030222 orthopedics
Debridement
Wound dehiscence
business.industry
Settore MED/19
030208 emergency & critical care medicine
Plastic Surgery Procedures
Middle Aged
medicine.disease
Surgery
Chronic osteomyelitis
Chronic Disease
General Earth and Planetary Sciences
Female
Flap necrosis
Complication
business
Leg Injuries
- Language
- ISSN
- 0020-1383
Introduction : Reconstruction of chronic lower extremity wounds can be especially challenging when the wounds are complicated by osteomyelitis. They require the joint expertise of plastic and orthopaedic surgeons. Methods : We report our experience in the use of the Keystone Perforator Island Flap following wound and bone debridement as a valuable surgical tool in the coverage of complex wounds with bone infection. Results : Twelve patients underwent similar procedures with overall good outcomes, although two patients experienced a complication specifically partial flap necrosis and wound dehiscence subsequent to recurrent osteomyelitis. We also reviewed the underlying physiological mechanisms of employing the keystone flap in order to demonstrate its advantages and efficacy. Conclusion : Our results confirm that the Keystone flap can be a safe, reliable and effective method for the coverage of soft tissue defects and the preservation of bone integrity in the management of patients with chronic osteomyelitis.