Island Perforator Muscle Flaps for Chronic Osteomyelitis of the Lower Extremities: A Retrospective Analysis of 21 Consecutive Cases

Background: One of the procedures for treating chronic osteomyelitis is the management of dead space resulting from aggressive debridement of the marrow cavity. To fill the void created by debridement, various muscle flaps have been recommended by many surgeons for their convenience and antiinfective properties. The objective of this study was to evaluate the efficacy of island perforator muscle flaps for the reconstruction of chronic osteomyelitis debridement defects of the lower extremities and provide indications for the selection of the muscle flap. Methods: A retrospective review of consecutive patients with chronic osteomyelitis of the lower extremities who underwent reconstruction using the island perforator muscle flap procedure from 2015 through 2018 was conducted. Data were collected on characteristics of the patients, wound site, wound size, surgical procedure, muscle choice, and wound healing. Results: For the 21 patients included in the study, all muscle flaps survived. Wounds healed completely within 4 weeks. No infection relapses were identified during the follow-up period of at least 12 months. Simple primary closure, with no additional incision in the donor site, was achieved in five patients. In eight patients, an additional incision was made to harvest a muscle flap, but both the wound and donor site were closed primarily. Conclusion: The results showed that the island perforator muscle flap is less invasive, easy to harvest, and effective, and can be a good choice for the management of dead space resulting from debridement for chronic osteomyelitis in the lower extremity. (Plast. Reconstr. Surg. 150: 677, 2022.)