Application of combining surgical skin flap grafting and bone transplanting in treatment of nosocomial infection of shank

Objective To sum up experience of combining surgical skin flap grafting and bone transplanting in treating soft tissue and bone defects caused after nosocomial infection after internal fixation of tibial fracture. Methods From Jun. 2009 to Feb. 2013,13 cases of osteomyelitis caused after nosocomial infection after internal fixation of tibial fracture were treated.Soft-tissue defects were repaired using free skin flap. Bone defects were repaired at second stage,and Ilizarov external fixator was used as a tool of distraction osteogenesis. Results The mean follow-up period was 14 months(range,6 to 48 months). Of all the flaps,wound healed on schedule in 10 cases whereas 3 cases emerged part necrosis,underwent cross leg skin flaps and local flap a second time,1 case succeed but 2 cases received amputation due to incurable and reversal infection.Osteanagenesis accomplished on schedule in 11 cases,6 of which knitted well,while bone grafting were operated between bone stumps in 5 cases. Conclusion The Ilizarov technique is a certified method solving bone defects and leads to osteoanagenesis,moreover,skin flap grafting(transferring) is needed frequently for skin covering following limbs wound,both above are beneficial to infection control and lead to satisfied results.