title: Coverage strategies in exposed implants.
abstract: Implants are widely used and are not without complications. The most serious complication is infection with consequent exposure of the implant and is characterized by increased morbidity and mortality. Until recently, infected implants were removed and replaced with another one. These operations are accompanied by increased morbidity and might result in permanent disability. Coverage of the implant with a flap is an alternative solution. The objective of this article is to study the effectiveness of muscle or myocutaneous flaps in covering infected and exposed implants. A series of 17 patients with infected implants, which were treated with coverage of the implant with muscle or myocutaneous flap, is presented. Eight patients had an orthopedic implant, seven a vascular implant, and two had a pacemaker. The flaps ensured immediate coverage of the implant and the biologic ability of eliminating the infectious process with the increased concentration of antibiotics resulting from increased blood flow of the muscle. In all the patients, the implants were preserved and the infectious process was eliminated. The use of muscle and myocutaneous flaps in the treatment of infected implants is therefore effective and in some cases it is superior to other methods because of lower morbidity and cost.
authors.affiliation: First Department of Surgery of the National and Kapodistrian University of Athens, Laikon Hospital, Athens, Greece. cyrosd@otenet.gr
authors.forename: Dimitris J
authors.initials: DJ
authors.lastname: Cyrochristos
authors.forename: Othon
authors.initials: O
authors.lastname: Papadopoulos
authors.forename: Christos
authors.initials: C
authors.lastname: Liapis
authors.forename: Evagelos L
authors.initials: EL
authors.lastname: Felekouras
authors.forename: Athanasios M
authors.initials: AM
authors.lastname: Giannopoulos
authors.forename: Elias
authors.initials: E
authors.lastname: Bastounis
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation*; D017410:Practice Guidelines as Topic; D019736:Prostheses and Implants; D016459:Prosthesis-Related Infections / Q000517:prevention & control*; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps; D013529:Surgical Wound Dehiscence / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult