Semin Plast Surg 2016; 30(02): 073-077
DOI: 10.1055/s-0036-1580728
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Orthopedic Prosthetic Infections: Plastic Surgery Management

Jesse D. Meaike
1   Division of Plastic and Reconstructive Surgery, Baylor College of Medicine, Houston, Texas
,
Matthew G. Kaufman
1   Division of Plastic and Reconstructive Surgery, Baylor College of Medicine, Houston, Texas
,
Shayan A. Izaddoost
1   Division of Plastic and Reconstructive Surgery, Baylor College of Medicine, Houston, Texas
› Author Affiliations
Further Information

Publication History

Publication Date:
04 May 2016 (online)

Abstract

Orthopedic prosthetic infections are potentially devastating complications. Plastic surgeons are frequently consulted to aid in the management of the soft tissue defects that are created by these infections. A review of the existing literature was performed to identify established treatment methods for soft tissue coverage of orthopedic hardware infections for a variety of anatomic locations. The following treatment guidelines and soft tissue reconstructive options were identified as viable options for the management of exposed or infected orthopedic hardware. This review provides descriptions of the various soft tissue reconstructive options available as well as adjunctive treatment methods.

 
  • References

  • 1 Gusenoff JA, Hungerford DS, Orlando JC, Nahabedian MY. Outcome and management of infected wounds after total hip arthroplasty. Ann Plast Surg 2002; 49 (6) 587-592
  • 2 Panni AS, Vasso M, Cerciello S, Salgarello M. Wound complications in total knee arthroplasty. Which flap is to be used? With or without retention of prosthesis?. Knee Surg Sports Traumatol Arthrosc 2011; 19 (7) 1060-1068
  • 3 Suda AJ, Cieslik A, Grützner PA, Münzberg M, Heppert V. Flaps for closure of soft tissue defects in infected revision knee arthroplasty. Int Orthop 2014; 38 (7) 1387-1392
  • 4 Cetrulo Jr CL, Shiba T, Friel MT , et al. Management of exposed total knee prostheses with microvascular tissue transfer. Microsurgery 2008; 28 (8) 617-622
  • 5 Nahabedian MY, Orlando JC, Delanois RE, Mont MA, Hungerford DS. Salvage procedures for complex soft tissue defects of the knee. Clin Orthop Relat Res 1998; (356) 119-124
  • 6 Viol A, Pradka SP, Baumeister SP , et al. Soft-tissue defects and exposed hardware: a review of indications for soft-tissue reconstruction and hardware preservation. Plast Reconstr Surg 2009; 123 (4) 1256-1263
  • 7 Cho EH, Garcia R, Pien I, Thomas S, Levin LS, Hollenbeck ST. An algorithmic approach for managing orthopaedic surgical wounds of the foot and ankle. Clin Orthop Relat Res 2014; 472 (6) 1921-1929
  • 8 Vaienti L, Di Matteo A, Gazzola R, Randelli P, Lonigro J. Distally based sural fasciomusculocutaneous flap for treatment of wounds of the distal third of the leg and ankle with exposed internal hardware. J Orthop Traumatol 2012; 13 (1) 35-39
  • 9 Choa R, Gundle R, Critchley P, Giele H. Successful management of recalcitrant infection related to total hip replacement using pedicled rectus femoris or vastus lateralis muscle flaps. J Bone Joint Surg Br 2011; 93 (6) 751-754
  • 10 Hollenbeck ST, Woo S, Komatsu I, Erdmann D, Zenn MR, Levin LS. Longitudinal outcomes and application of the subunit principle to 165 foot and ankle free tissue transfers. Plast Reconstr Surg 2010; 125 (3) 924-934
  • 11 Choudry UH, Moran SL, Li S, Khan S. Soft-tissue coverage of the elbow: an outcome analysis and reconstructive algorithm. Plast Reconstr Surg 2007; 119 (6) 1852-1857
  • 12 Hochberg J, Ardenghy M, Yuen J , et al. Muscle and musculocutaneous flap coverage of exposed spinal fusion devices. Plast Reconstr Surg 1998; 102 (2) 385-389 , discussion 390–392
  • 13 Mericli AF, Mirzabeigi MN, Moore Jr JH, Fox IV JW, Copit SE, Tuma GA. Reconstruction of complex posterior cervical spine wounds using the paraspinous muscle flap. Plast Reconstr Surg 2011; 128 (1) 148-153
  • 14 Wen G, Wang CY, Chai YM, Cheng L, Chen M, Yi-Min LV. Distally based saphenous neurocutaneous perforator flap combined with vac therapy for soft tissue reconstruction and hardware salvage in the lower extremities. Microsurgery 2013; 33 (8) 625-630
  • 15 Lehner B, Fleischmann W, Becker R, Jukema GN. First experiences with negative pressure wound therapy and instillation in the treatment of infected orthopaedic implants: a clinical observational study. Int Orthop 2011; 35 (9) 1415-1420