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#1
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11-14-2022, 07:55 PM
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 These are the rooms Poster Rank:25 of ruin. Join Date: Sep 2014 Posts: 54,011 Mentioned: 145 Post(s) Quoted: 30403 Post(s)
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Fracture and Infection.
A 50-year-old man sustained a Gustilo-Anderson type IIIB fracture of the right calcaneus after a fall from a height. He was referred to our hospital 1 month after having undergone an open reduction and internal fixation at a peripheral hospital. He presented with the complaint of a discharging wound on the right foot. A physical examination revealed an infected deep wound on the right foot, and radiological examinations showed evidence of chronic osteomyelitis. The patient had a preoperative angiography to reveal the vascular anatomy of the right lower limb. The posterior tibial artery, peroneal arteries, and anterior tibial arteries were all patent. Multiple wound debridement and radical bone resection resulted in a large soft tissue defect measuring 10 cm × 8 cm and a total calcaneal bone defect [Figure - 1]. He underwent a two-stage reconstruction: a free ALT flap in the first stage to reconstruct the soft tissue defect, and in the second stage, a free vascularized fibula osteocutaneous flap to reconstruct the calcaneal defect. The ALT free flap was performed 8 weeks after the initial injury [[Figure - 2]a]. The recipient vessels were the anterior tibial artery and anterior tibial vein. The flap survived, and there were no donor site complications. An antibiotic bead pouch was inserted and changed twice fortnightly until there was no clinical and laboratory evidence of infection [[Figure - 2]b].  ·  ·  ·  ·  · |
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#2
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12-09-2022, 02:15 PM
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 Wide 'n' sassy Poster Rank:1248 Female Join Date: Mar 2009 Posts: 497 Mentioned: 5 Post(s) Quoted: 69 Post(s)
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Re: Fracture and Infection.
An antibiotic bead pouch is a new one to me. Sounds...crafty.
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