ArticleJournal of orthopaedic surgery and research2021
Factors affecting the outcome of lower extremity osteomyelitis treated with microvascular free flaps: an analysis of 65 patients.
Article in Journal of orthopaedic surgery and research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.
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Who cites it
7 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Diabetic Foot Ulceration in Dialysis-Dependent End-Stage Kidney Disease: A Systematic Review of Epidemiology, Clinical Outcomes and Mortality Risk.Diabetes/metabolism research and reviews · 2026Pooled it
- Meta-analysis of the safety and efficacy of flap reconstruction in the treatment of diabetic foot ulcers.BMC surgery · 2026Pooled it
- Preoperative Surgical-Field Antisepsis with a pH-Optimized Sodium Hypochlorite Wound Cleanser in Microsurgical Diabetic Foot Reconstruction: A Single-Center Feasibility Study.Journal of clinical medicine · 2026Article
- Risk Factors Associated with Adverse Functional Outcomes in Free Flap Reconstructions of the Lower Extremity.Plastic and reconstructive surgery. Global open · 2026Article
- Article
- Tissue Oximetry Changes during Postoperative Dangling in Lower Extremity Free Flap Reconstruction: A Pilot Study.Life (Basel, Switzerland) · 2023Article
- [Research advances on the application of free flaps in repairing diabetic foot ulcers].Zhonghua shao shang yu chuang mian xiu fu za zhi · 2023Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFree flaps have been a useful modality in the management of lower extremity osteomyelitis particularly in limb salvage. This study aimed to determine the factors affecting the outcome of free flap reconstruction in the treatment of osteomyelitis.
methodsThis retrospective study assessed 65 osteomyelitis patients treated with free flap transfer from 2015 to 2020. The treatment outcomes were evaluated in terms of the flap survival rate, recurrence rate of osteomyelitis, and amputation rate. The correlation between outcomes and comorbidities, causes of osteomyelitis, and treatment modalities was analyzed. The following factors were considered: smoking, peripheral artery occlusive disease, renal disease, diabetic foot ulcer, flap types, using antibiotic beads, and negative pressure wound therapy.
resultAmong the 65 patients, 21 had a severe peripheral arterial occlusive disease. Osteomyelitis developed from diabetic foot ulcers in 28 patients. Total flap failure was noted in six patients, and osteomyelitis recurrence was noted in eight patients, for which two patients underwent amputation surgery during the follow-up period. Only end-stage renal disease had a significant correlation with the recurrence rate (odds ratio = 16.5, p = 0.011). There was no significant relationship between outcomes and the other factors.
conclusionThis study showed that free flaps could be safely used for the treatment of osteomyelitis in patients with comorbidities and those who had osteomyelitis developing from diabetic foot ulcers. However, care should be taken in patients diagnosed with end-stage renal disease.
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