title: Chronic osteomyelitis of the spine managed with a free flap of latissimus dorsi. A case report.
abstract: METHODS
  A patient with intractable spinal osteomyelitis who underwent surgery 12 times with persistent exposed bone is presented.
  
  
  OBJECTIVE
  To demonstrate the effectiveness of free-flap grafting for managing difficult spinal osteomyelitis wounds.
  
  
  BACKGROUND
  Conventional procedures can usually achieve wound closure, but they may not work for advanced cases.
  
  
  METHODS
  A free latissimus dorsi flap was transferred for reconstruction. The muscle component was used to obliterate the dead space and cover the exposed bone, and the skin component was used for tension-free closure of the wound.
  
  
  RESULTS
  The wound healed dramatically. There was no recurrence of infection at 2-year follow-up evaluation.
  
  
  CONCLUSIONS
  For an intractable spinal osteomyelitis wound, a free flap should be considered, although the surgery is difficult. Technical precautions in performing this operation are given.
authors.affiliation: Department of Plastic Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: H C
authors.initials: HC
authors.lastname: Chen
authors.forename: H H
authors.initials: HH
authors.lastname: Chen
authors.forename: W J
authors.initials: WJ
authors.lastname: Chen
authors.forename: Y B
authors.initials: YB
authors.lastname: Tang
mesh_terms: D002908:Chronic Disease; D005260:Female; D006801:Humans; D007796:Laminectomy; D008875:Middle Aged; D009132:Muscles / Q000637:transplantation; D010019:Osteomyelitis / Q000209:etiology / Q000601:surgery*; D019233:Retreatment; D016038:Skin Transplantation; D013122:Spinal Diseases / Q000209:etiology / Q000601:surgery*; D013130:Spinal Stenosis / Q000601:surgery; D013131:Spine / Q000601:surgery; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000150:complications