Experimental evaluation of free-tissue transfer to promote healing of infected wounds in dogs.
An experimental model was designed to evaluate the course of healing and the changes in bacterial concentrations of infected forelimb wounds with devascularized bone in dogs. Infected leg wounds were allowed to heal by secondary intention or were covered with a full-thickness or split-thickness skin graft, an epigastric skin/fat flap, or a gracilis musculocutaneous flap. All skin grafts failed. Gracilis muscle flaps were superior to epigastric skin/fat flaps in decreasing soft-tissue bacterial concentrations. Quantitative bone cultures, however, were positive at reexploration 6 weeks later in 33% of all legs covered with a flap. X-ray films were successful in predicting the presence or absence of bone infection in 70% of all legs. Postmortem arteriograms of legs covered with muscle flaps showed neovascularity to bone. This study suggests muscle flap coverage of wounds debrided of contaminated, necrotic, or infected bone and soft tissue to be an excellent method of providing well-vascularized soft tissue promoting healing and resolution of infection.
Asaadi
M
M
Division of Plastic and Reconstructive Surgery, Southern Illinois University School of Medicine, Springfield 62708.
Murray
K A
KA
Russell
R C
RC
Zook
E G
EG
D000818:Animals; D001458:Bandages; D004195:Disease Models, Animal; D004285:Dogs; D005552:Forelimb / Q000293:injuries / Q000382:microbiology / Q000601:surgery; D013524:Surgical Flaps / Q000379:methods*; D014945:Wound Healing; D014946:Wound Infection / Q000382:microbiology / Q000601:surgery*