Abstract
We retrospectively investigated the clinical outcomes of soft tissue reconstruction for crushed and contaminated wounds in the extremities at our hospital. We examined 20 wounds in 18 patients: 8 on the hand, 2 on the forearm, 1 on the upper arm, and 9 on the lower leg. Eight wounds were associated with open fracture, 7 were contaminated by soil and/or organic matter, and 12 had bacterial infections. Eleven wounds were covered with free flaps and 9 with pedicled flaps. The average period to soft tissue reconstruction was 16 days. All wounds healed, and the average period until complete wound healing was 40 days. Nine wounds developed postoperative infection, including one case of delayed osteomyelitis. Eleven wounds required additional procedures, including additional debridement under the flaps in 7. All 4 wounds that were positive on wound culture before soft tissue reconstruction developed postoperative infection under the flaps. As it is difficult to perform debridement for contaminated wounds, wound infection can continue postoperatively. For wounds with infection after soft tissue reconstruction, additional debridement under the flaps should be performed, paying attention to flap circulation.
