OBJECTIVETo investigate the efficacy of surgical method with the soleus muscle flap for repairing the soft-tissue defects in the middle and distal thirds of the leg, combined with open tibial fracture and/or osteomyelitis.

METHODSFrom May 2007 to December 2011, 8 cases with soft-tissue defects in the middle and distal thirds of the leg were treated with soleus muscle flaps, including 5 cases with chronic osteomyelitis and 3 cases with open tibial fracture and acute osteomyelitis. The defects size ranged from 8 cm x 6 cm to 12 cm x 10 cm. The surface of muscle flaps was covered by split-thickness skin graft. The defects at the donor site were closed directly.

RESULTSAll the muscle flaps and skin grafts survived completely and fracture was healed. The patients were followed up for 2 to 54 months with satisfactory cosmetic and functional results.

CONCLUSIONSThe soleus muscle flap is an effective and feasible method for reconstruction of the soft-tissue defects in the middle and distal thirds of the leg, combined with open tibial fracture and/or osteomyelitis. The morbidity at donor sites is also minor.

Adult ; Female ; Fractures, Open ; complications ; Humans ; Leg Injuries ; complications ; surgery ; Male ; Middle Aged ; Muscle, Skeletal ; transplantation ; Osteomyelitis ; complications ; Soft Tissue Injuries ; complications ; surgery ; Surgical Flaps ; Tibial Fractures ; complications ; Treatment Outcome ; Young Adult

OBJECTIVETo compare the differences of the clinical effects, side effects and treatment-related cost between two kinds of negative-pressure wound therapy (NPWT).

METHODSForty-four inpatients with acute, subacute, and chronic wounds were divided into simplified NPWT group (A group) and conventional NPWT group (B group) according to the random number table. Wounds of patients in A group were treated with gauze + continuous suction with hospital central negative pressure (-10.64 kPa) for 24 hs; wounds of patients in B group were treated with sponge + interrupted suction with a purpose-designed suction appliance (-16.63 kPa) for 24 hs. Gross wound condition, treatment time, survival rates of skin graft and flap, changes of bacterial species on wound, treatment cost, and ratio of side effects between two groups were compared.

RESULTSThere was no significant difference between A and B groups in respect of gross wound condition, treatment time [A group (29 +/- 12) d, B group (26 +/- 13) d, P > 0.05], changes of bacterial species, survival rates of skin graft [A group (98 +/- 4)%, B group (98 +/- 4)%, P > 0.05] and flap (A group 98%, B group 100%, P > 0.05). Treatment cost of A group yen(374 +/- 134) was obviously lower than that of B group yen(9825 +/- 4956) (P < 0. 01), while more side effects were observed in A group (33.3%) than that in B group (5.0%) (P < 0.05).

CONCLUSIONSBoth simplified NPWT and NPWT with purpose-designed appliance can effectively improve wound healing. The simplified method may cause many side effects and has a potential risk of inciting nosocomial infection, but it can be conveniently employed with a low cost. In contrast, the cost of using purpose-designed appliance should be cut down to meet the aim of generalization.

Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Negative-Pressure Wound Therapy ; methods ; Wound Healing ; Young Adult

OBJECTIVETo study the effects of negative-pressure wound therapy (NPWT) on the treatment of complicated and refractory wounds.

METHODSSixty-seven patients with complicated or refractory wounds admitted to our hospital from September 2005 to November 2008 were randomly divided into NPWT group (n = 35) and conventional treatment (CT) group (n = 32). Wounds of patients in NPWT group were treated with interrupted suction under a pressure of -16.63 kPa for 24 hs, or continuous suction under a pressure of -10.64 kPa for 24 hs. Wounds of patients in CT group were covered with petrolatum gauze overlaid with isotonic saline gauze and dry gauze. Duration of treatment, times of operation, treatment cost, and the process of healing were compared between two groups.

RESULTSThe duration of treatment, treatment cost and times of operation of patients in NPWT group were obviously less or fewer than those of CT group (P < 0.05). Wounds of patients in NPWT group were mainly healed by themselves (40.0%) or healed after free skin grafting (40.0%). While wounds in patients in CT group healed mainly after tissue flap transplantation (66.7%) or free skin grafting (23.3%).

CONCLUSIONSCompared with CT, NPWT can shorten the length of hospital stay, reduce operation frequency and treatment cost, and it is easier to carry out in the surgery of treating complicated and refractory wounds, which is worth generalization.

Adult ; Aged ; Diabetic Foot ; surgery ; Female ; Humans ; Male ; Middle Aged ; Negative-Pressure Wound Therapy ; Pressure Ulcer ; surgery ; Wound Healing