The current state of the problem of soft tissue defects replacement in the lower extremities in conditions of chronic osteomyelitis

Abstract

Based on the data of scientific literature, the current state of the problem of soft tissue defects replacement in the lower extremities in conditions of chronic osteomyelitis has been analyzed. Taking into account certain requirements for the replacement of defects of this nature, the following reconstructive tasks have been indicated. First of all, for adequate restoration of the skin with simultaneous relief of the purulent-necrotic process, it is necessary to use blood-supplied tissue complexes, which, if possible, should be formed from tissues similar to those surrounding the defect. The predominant use of technically and economically beneficial interventions is of great importance. The most suitable are loco-regional flaps with axial blood supply, among which the most promising are perforant flaps. It is necessary to develop an algorithm for defects reconstruction using loco-regional perforant flaps, depending on the defect area. It is also necessary to conduct a comparative analysis of the anatomical advantages and effectiveness of using various perforant and insular flaps on the vascular pedicle. A one-stage orthoplastic approach will allow the most effective use of the achievements of reconstructive plastic surgery in orthopedics to restore limb function, which will improve the results of treatment of patients.

Keywords

• chronic osteomyelitis
• soft tissue defects of extremities
• perforant flaps
• flaps with axial blood supply
• loco-regional flaps