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Plastic solutions for orthopaedic problems.

V J Bihariesingh·Ewa M Stolarczyk·Refaat B Karim·E Oscar van Kooten
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Abstract

INTRODUCTION: Infection and exposure of the implant may occur in 1-12% of patients operated on for arthroplasty or osteosynthesis. Variables such as tissue viability, presence of infection, exposure of osteosynthesis material and patient-related factors contribute to the lack of general consensus regarding the management of these defects. MATERIALS AND METHODS: Between January 1999 and January 2001, six patients were treated for complex soft-tissue defects following various orthopaedic procedures at the Department of Plastic Surgery in the Slotervaartziekenhuis in Amsterdam, a rheuma-orthopaedic orientated hospital. All patients were initially treated by radical debridement and vacuum-assisted closure (VAC) system of the wound. After 1 week, this was followed by transplantation of a pedicled or free flap to cover the defect. We studied the medical history, initial orthopaedic procedure, wound treatment, transplanted flap and outcome of plastic surgery in this group. RESULTS: Plastic surgical intervention led to wound closure in all cases. In only one case was the osteosynthesis material removed because of osteomyelitis. CONCLUSIONS: We conclude that the earlier coverage with vital tissue is obtained, the lower the incidence of infection. Early consultation by a plastic surgeon will increase a positive outcome of treatment of complex tissue defects.

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AdultAgedArthroplastyDebridementFemaleFracture Fixation, InternalHumansMaleMiddle AgedMuscle, SkeletalOcclusive DressingsPlastic Surgery ProceduresSurgical FlapsSurgical Wound DehiscenceTreatment OutcomeVacuumWound HealingJournal Article

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V J Bihariesingh, Ewa M Stolarczyk, Refaat B Karim, E Oscar van Kooten. 2004-01-17. Plastic solutions for orthopaedic problems.. https://doi.org/10.1007/s00402-003-0615-8

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