Abstract
Background
Management of chronic osteomyelitis (COM) remains a challenge for plastic and orthopedic
surgeons. Among many perforator flaps utilized in COM, chimeric flaps reported superior
successful outcomes. The objective of this study is to evaluate the efficacy of chimeric
superficial circumflex iliac artery perforator (SCIP) in treatment of various forms
of COM.
Methods
A retrospective analysis was performed of all patients with posttraumatic COM who
underwent reconstruction using chimeric SCIP flaps between September 2019 and November
2023. Patients with insufficient data or follow-up less than 1 year were excluded
from the study. The preoperative basic data and the operative details and postoperative
follow-up data were collected and statistically analyzed. Correlation between recurrence
and the following factors was analyzed: comorbidities, type of trauma, duration of
COM, and limb vascularity condition.
Results
A total of 59 patients were analyzed, with a mean age 35.31 years. A total of 29 patients
underwent chimeric SCIP skin–iliac bone flap reconstruction, 16 received chimeric
skin–iliac periosteal flaps, and 4 had chimeric flaps combining skin, periosteum,
and bone. There were two cases of total flap loss and two cases of partial flap loss.
Additionally, three patients (5.08%) experienced a recurrence of COM. The significant
predictor of COM recurrence was major vascular injury. Although not statistically
significant, COM recurrence was more prevalent among patients with comorbidities,
smoking, and diabetes.
Conclusion
Chimeric SCIP flaps can be effectively used to treat COM with composite tissue defects,
eliminate inflammation of the affected limbs, allow composite tissue reconstruction,
and promote wound healing.
Keywords
chronic osteomyelitis - SCIP flap - chimeric flap
