Choosing between Muscle and Fasciocutaneous Free Flap Reconstruction in the Treatment of Lower Extremity Osteomyelitis: Available Evidence for a Function-Specific Approach.
Journal
Journal of reconstructive microsurgery
ISSN: 1098-8947
Titre abrégé: J Reconstr Microsurg
Pays: United States
ID NLM: 8502670
Informations de publication
Date de publication:
Mar 2020
Mar 2020
Historique:
pubmed:
8
10
2019
medline:
20
1
2021
entrez:
8
10
2019
Statut:
ppublish
Résumé
Limb salvage in the setting of extremity osteomyelitis, though previously dependent on amputation, has been markedly improved through the application of free tissue flaps. Concern exists as to the utility of the fasciocutaneous flap to combat infection verses the traditional muscle flap. Prior studies have shown success with fasciocutaneous flaps in these patients, but given the small series, the choice remains controversial. The goal of this article was to determine if there is statistical evidence for flap choice in the setting of extremity osteomyelitis. A systematic review utilizing Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was completed of the current literature pertaining to the treatment of extremity osteomyelitis and flap reconstruction within the MedLine and PubMed databases. Six hundred forty-six studies were reviewed and ultimately 31 were included in the final analysis. Eight hundred seventy-eight flap reconstructions were identified. Of the 588 muscle flaps, 7.8% ( Selection of flap type is less important than adequate debridement, appropriate antibiotic selection, and sufficient duration of treatment. This study demonstrates that within the literature, fasciocutaneous flaps have a lower recurrence rate of osteomyelitis compared with muscle flaps. As such, fasciocutaneous flaps are appropriate for reconstruction and treatment of extremity osteomyelitis.
Sections du résumé
BACKGROUND
BACKGROUND
Limb salvage in the setting of extremity osteomyelitis, though previously dependent on amputation, has been markedly improved through the application of free tissue flaps. Concern exists as to the utility of the fasciocutaneous flap to combat infection verses the traditional muscle flap. Prior studies have shown success with fasciocutaneous flaps in these patients, but given the small series, the choice remains controversial. The goal of this article was to determine if there is statistical evidence for flap choice in the setting of extremity osteomyelitis.
METHODS
METHODS
A systematic review utilizing Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was completed of the current literature pertaining to the treatment of extremity osteomyelitis and flap reconstruction within the MedLine and PubMed databases. Six hundred forty-six studies were reviewed and ultimately 31 were included in the final analysis.
RESULTS
RESULTS
Eight hundred seventy-eight flap reconstructions were identified. Of the 588 muscle flaps, 7.8% (
CONCLUSION
CONCLUSIONS
Selection of flap type is less important than adequate debridement, appropriate antibiotic selection, and sufficient duration of treatment. This study demonstrates that within the literature, fasciocutaneous flaps have a lower recurrence rate of osteomyelitis compared with muscle flaps. As such, fasciocutaneous flaps are appropriate for reconstruction and treatment of extremity osteomyelitis.
Identifiants
pubmed: 31590192
doi: 10.1055/s-0039-1698469
doi:
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
197-203Informations de copyright
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Déclaration de conflit d'intérêts
None declared.