The Efficacy of Chimeric Superficial Circumflex Iliac Artery Perforator (SCIP) Flap in Treatment of Posttraumatic Chronic Osteomyelitis.

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.