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The role of free flaps in the treatment of persistent scalp osteomyelitis.

AbstractOBJECTIVE:
To evaluate the efficacy of the combination of an extensive surgical debridement and simultaneous free flap repair in case of troublesome cranial osteomyelitis.
METHODS:
Five patients with persistent, frontal bone osteomyelitis were treated with surgical debridement of the infected bone and reconstruction with a free flap. In all patients, osteomyelitis occurred after neurosurgical procedures and lasted from 1 to 7 years. A latissimus dorsi muscle flap with a split skin graft has been performed.
RESULTS:
No flap failure occurred and donor site morbidity was negligible. No signs of osteomyelitis or soft tissue infection were observed during the mean follow-up period of 3.2 years. Furthermore, the contour of the cranium could be preserved without a need for bone grafts or implants.
CONCLUSION:
In our experience, the combination of an extensive surgical debridement and a free flap transfer is demonstrated to be an effective treatment for "chronic" osteomyelitis of the cranium.
AuthorsWilly D Boeckx, René R W J van der Hulst, Lloyd V Nanhekhan, Francesca De Lorenzi
JournalNeurosurgery (Neurosurgery) Vol. 59 Issue 1 Suppl 1 Pg. ONS64-7; discussion ONS64-7 (Jul 2006) ISSN: 1524-4040 [Electronic] United States
PMID16888553 (Publication Type: Clinical Trial, Journal Article)
Topics
  • Adolescent
  • Adult
  • Aged
  • Chronic Disease (therapy)
  • Debridement (methods)
  • Female
  • Frontal Bone (microbiology, pathology, surgery)
  • Humans
  • Male
  • Middle Aged
  • Neurosurgical Procedures (adverse effects, methods)
  • Osteomyelitis (etiology, physiopathology, surgery)
  • Plastic Surgery Procedures (methods)
  • Reoperation
  • Scalp (microbiology, physiopathology, surgery)
  • Skull (microbiology, pathology, surgery)
  • Staphylococcal Infections (complications, physiopathology)
  • Surgical Flaps
  • Surgical Wound Infection (microbiology, physiopathology, surgery)
  • Treatment Outcome

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