MUSCLE FLAP CLOSURE FOR SALVAGE OF COMPLEX BACK WOUNDS

Study Design. The use of muscle flaps for closing complex thoracolumba r and lumbar spine wounds was studied retrospectively. Five patients i n whom traditional, conservative treatment modalities did not work und erwent a variety of muscle flap closures with successful healing. Obje ctives. Patients with complicated back wounds ranging from exposed har dware to post-traumatic defects were treated initially with conservati ve treatments. The authors evaluated the efficacy of applying techniqu es and knowledge gained from complex lower extremity wound coverage of back wounds. Summary of Background Data. Six muscle transfer procedur es were performed on five patients. All patients were closed with loca l muscle flaps using the trapezius and latissimus dorsi muscles. Metho ds. Success was defined as a closed stable wound that needed no future surgery nor allowed the primary defect to heal before hardware remova l. There was no evidence of chronic infection. Surgical hardware was s alvaged in one of three patients. Results. All were successfully close d and have been followed up to 30 months without evidence of recurrenc e. Conclusions. The cases presented illustrate the usefulness of rotat ion flaps when there is an extensive soft tissue defect that has expos ed neural, osseous, and foreign structures. The use of local transposi tion muscle flaps as an adjunct in closing complex back wounds has bee n very successful in our experience. Although recurrent infection may occur, this technique has facilitated the establishment of a soft tiss ue envelope to achieve short- and long-term wound healing.