Local muscle flaps in the treatment of XXXX .

@entity1 @entity154 @entity6275 @entity796 @entity174 @entity75 @entity8213 @entity4034 @entity121 @entity130
When large soft-tissue and @entity154 remain after d  bridement of a chronic @entity75 , application of a local muscle flap can be an effective way to achieve wound closure. Utilizing this surgical technique and specific antimicrobial therapy for the causal microorganisms, the infectious process was eradicated in thirty-nine of forty-two @entity1 with @entity4034 who were followed for at least two years after treatment. The osteomyelitic process was post-traumatic in origin--that is, a complication of a @entity174 or its treatment--in twenty-eight @entity1 , the result of soft-tissue @entity130 without a @entity174 in eight, a complication of elective surgery in three, and the result of hematogenous seeding in three @entity1 . Nine of the forty-two @entity1 had an infected non-union. The infectious process involved the tibia in 62 per cent of the @entity1 . @entity796 was the most frequently isolated causal organism. A soleus or gastrocnemius muscle flap was most frequently utilized to achieve closure. In five @entity1 , a combination of two muscle flaps was utilized. Although this technique successfully eradicated the infectious process in 93 per cent of the @entity1 , twenty-two @entity1 required additional surgical treatment. Six required such treatment for a persistent non-union and two, for weakened diaphyseal bone after eradication of the septic process. A cancellous bone-grafting procedure was performed in all eight @entity1 after the muscle flap had healed, and union was achieved in six of them. One @entity1 eventually requested an amputation for a persistent non-union, and the remaining @entity1 had a fibular @entity8213 performed for a persistent tibial non-union. A local muscle flap can be used in @entity1 with a large defect of soft tissue and bone after d  bridement of an @entity75 if the flap can be elevated and transposed into the defect without compromising its vascular supply. Although they are not applicable to the treatment of all @entity1 with @entity4034 , @entity121 can be extremely useful in the treatment of this lesion. When combined with thorough d  bridement and specific antimicrobial therapy, it has become a successful technique in the management of @entity6275 .
