One-stage reconstruction of war wounds with free osteocutaneous flaps

• Published in: British journal of plastic surgery 1997-02, Vol.50 (2), p.81-87
• Main Authors: Dzˇepina, I., Stanec, Z., Sˇkrbić, S., Hulina, D., Ivrlacˇ, R., Unusˇić, J., Montani, D.
• Format: Article
• Language: English
• Subjects: Adult; Arm Injuries - surgery; Biological and medical sciences; Blast Injuries - surgery; Bone Transplantation; Bosnia and Herzegovina; Croatia; Follow-Up Studies; Humans; Leg Injuries - surgery; Male; Medical sciences; Middle Aged; Orthopedic surgery; Skin Transplantation; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgical Flaps - methods; Treatment Outcome; Warfare; Wounds and Injuries; Wounds, Penetrating - surgery
• ISSN: 0007-1226; 1465-3087
• DOI: 10.1016/S0007-1226(97)91318-7

Thirty-one patients with traumatic osteocutaneous defects of the extremities sustained during the war in Croatia and Bosnia and Herzegovina were treated at the Institute of Plastic-Reconstructive and Breast Surgery in Zagreb. Injuries were categorised using the Mangled Extremity Syndrome Index (MESI). The average length of bone defect was 5.9 cm (range 4–12 cm). Patients were divided in two groups according to the time they had reconstruction with a free osteocutaneous flap: group 1, within 6 days after injury, and group 2, after more than 6 days. The mean time to reconstruction in group 2 was 5.2 weeks. Average time to solid bone union was 13.3 weeks in group I and 16.6 weeks in group 2. Functional outcome was better in group 1 with fewer complications, smaller number of operations and shorter hospital stay. One-stage reconstruction of osteocutaneous defects with free composite flaps provides reliable treatment solution with good functional outcome.