Is delayed reconstruction using the latissimus dorsi free flap a worthy option in the management of open IIIB tibial fractures

摘要: Early reconstruction of severe open fractures, performed within 7 days the injury, has a better outcome than closure after days. However, uncertain demarcation damaged tissue often results in delayed reconstruction. In this article, we report our surgical outcomes using latissimus dorsi free flap with internal fixation. Twenty-three patients Gustilo type IIIB tibial fractures Between March 2009 and May 2012 were included study. There 16 cases distal 1/3 fracture tibia, 4 midshaft fracture, 1 proximal 2 segmental fracture. Serial debridement application negative pressure wound therapy (NPWT) was before final operation. All underwent fixation bone soft defect flap. The number serial debridements, excluding those during emergency finial operation, ranged from to 5 (mean 2.69) times. Mean time injury operation 10.65 (range, 7-22) flaps survived without complications. Three (13%) infected, three required further graft surgery facilitate union (13%). Bone achieved mean 6.3 3-12) months. follow-up period 16.34 12-26) During follow-up, all able ambulate use an aid. treatment should emphasize coverage rather rushing achieve definitive setting poor surrounding tissues. When is inevitable, radical first, then NPWT used as bridging therapy, could be considered for definite tissues coverage. © 2015 Wiley Periodicals, Inc. Microsurgery 36:453-459, 2016.