Free Flap and Osteocutaneous Flap Transfer in the Treatment of Infected Wound

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Journal of the Korean Society for Surgery of the Hand 2004;13(2):136-143.
Published online October 31, 2004.

Kwang Suk Lee, M.D., Jong Ryoon Baek, M.D., Sang Bum Kim, M.D., Dae Hee Lee, M.D., Woo Joo Jeon, M.D.

감염 창상 치료에 있어 유리 피부 및 생골 피부편 이식

이광석·백종륜·김상범·이대희·전우주

Abstract

Purpose: We analyse retrospectively the clinical result of consecutive free flap and osteocutaneous flap transfer in the chronic osteomyelitis, nonunion combined with infection and soft tissue defect with infection.
Materials and Methods: From December 1989 to Jun 2003, free flap and osteocutaneous flap transfer was performed in 225 patients with osteomyelitis or infected non-union. 44 cases of these patients had revealed antibitotics resistant organism in wound culture, and these 44 cases were investigated in the mechanism of the injury, recurrence of infection, radiographic union, follow-up clincal results, and postoperative complications.
Results: Among the 44 cases, consecutive procedures of osteocutaneous flap transfers(26 cases) and free flaps(18 cases) were performed. Causative organisms were MRSA(20 cases), Pseudomonas aeruginosa(18 cases), acinetobacter(2 cases), and so forth. Initial bony union was obtained in the average 6.3 months. Recurrence of infection in free flap and osteocutaneous free flap were occurred in 3 and 4 cases respectively. Eventually, all the cases attained successful subsidence of the inflammation.
Conclusion: Free flap and osteocutaneousflap transfer have provided the greatest improvement of surgical results in infected non-union, chronic osteomyelitis and soft tissue defect with infection. Further clincal studies maybe required to minimize failure rate.

Key Words: Infected wound, Free flap transfer, Osteocutaneous flap transfer

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