Complex wounds in the hip region often result from complications of orthopedic procedures performed in this region such as total hip arthroplasty, ORIF procedures, tumor ablation, and/or radiation therapy. Exposure of bone, joint capsule, prostheses, and other hardware often results with these wounds. Salvage of these exposed and/or infected essential elements and providing soft-tissue coverage are difficult and challenging problems for the orthopedic and plastic surgeon. To provide coverage for such situations, we have developed an aggressive strategy of thorough debridement, systemic antibiotics, and well-vascularized soft-tissue coverage utilizing an inferiorly based rectus abdominis island flap. This technique was utilized in five patients with all wounds and joints remaining stable at follow-up periods ranging from 2 to 7 years.
From the Division of Plastic and Reconstructive Surgery, Department of Surgery, at Case Western Reserve University School of Medicine. Received for publication November 9, 1994; revised July 5, 1995.
Brian H. Windle, M.D.
Division of Plastic and Reconstructive Surgery University Hospitals of Cleveland 11100 Euclid Avenue Cleveland, Ohio 44106