DOS 2018

DOS Kongressen 2018 · 205 Treatment of osteomyelitis of the lower extremity with fasciocutaneous free flaps compared to muscle free. Signe Muus Steffensen, Birgitte Jul Kiil, Hans Henrik Møller Nielsen, Klaus Kjær Petersen Plastic surgery, Aarhus University hospital; Plastic surgery, Aarhus; orthopedic surgery, Aarhus University hospital Background: Treatment of osteomyelitis is a challenge. Coverage of significant soft tissue defects after bone and soft tissue debridement with associated bony dead space was traditionally performed with free muscle flaps (M) and is still the preferred approach by many surgeons. Free fasciocutaneous flaps (FC) can provide the same degree of coverage and bulk. Purpose / Aim of Study: The aim of this study is comparison of (M) and (FC) according to overall complication rates, donorsite morbidity, post-op mobiliza- tion, safety of procedure if later surgery is required due to recurrence of osteo- myelitis and the advantage of liposuction of (FC). Materials and Methods: A retrospective review was conducted of all free flap reconstructions after osteomyelitis debridement in the lower leg from 2004 to 2018 at Aarhus university hospital. Findings / Results: 16 patients underwent free flap reconstruction after os- teomyelitis debridement. (8 (M=Gracilis flaps) and 8 (FC=Anterolateral thigh flaps (ALT)). 15 flaps healed completely, 1 (M) flap was lost due to venous con- gestions. 7 (M) had minor complications, 8 (FC) with no complications. None experienced recurrence of osteomyelitis. Equal low donorsite morbidity was found in both groups according to sensibility and function. Early post-op full weight-bearing mobilization was experienced in (FC = 1 week) compared to (M = 3 weeks). The advantage of thinning with liposuction of (FC) for refinement of functional and cosmetic outcome was compared to (M). Conclusions: Conclusion: Fasciocutaeus free faps are superior to muscle free flaps in several aspects in the use of covering defects after osteomyelitis de- bridement with bony dead space in lower limb reconstructions. 146.