Introduction: Chronic osteomyelitis cases are challenging,
as they require a multidisciplinary approach for reconstructive
soft tissue coverage and orthopedic management. Proper
debridement, stable coverage and effective antibiotic therapy
are mandatory before application of flap coverage.
Patients and Methods: We performed a retrospective
comparative study between muscle and fasciocutaneous flaps
used for coverage of chronic osteomyelitis related wounds of
the lower limb. It included thirty patients who finished a 12
months of follow-up to assess the complications rate and the
outcome of surgery. Color match, texture match and aesthetic
satisfaction were compared between the 2 groups.
Results: Thirty-one flaps including six free flaps and
twenty-five local flaps were used to treat these cases. Complications
included fluid collections in one case, sinus formation
in two 2 cases, partial flap loss in one case. These
complications were managed by prolonged antibiotic therapy
and dressing changes. Cases in group B had higher scores
(mean: 9.5±1.34) in comparison with cases in group A (mean:
7.25±1.29). Yet, there were no statistically significant differences
between the 2 groups (p-value: 0.27).
Conclusion: A multidisciplinary team is needed for management
of cases with chronic osteomyelitis related wounds.
Flap coverage can be achieved with either muscular or fasciocutaneous
flaps with comparable successful rates.