Study finds, Factors affecting the outcome of lower extremit
Free flaps have been a useful modality in the management of lower extremity osteomyelitis particularly in limb salvage. This study aimed to determine the factors affecting the outcome of free flap reconstruction in the treatment of osteomyelitis.

This retrospective study assessed 65 osteomyelitis patients treated with free flap transfer. The treatment outcomes were evaluated in terms of the flap survival rate, recurrence rate of osteomyelitis, and amputation rate. The correlation between outcomes and comorbidities, causes of osteomyelitis, and treatment modalities was analyzed.

--Among the 65 patients, 21 had a severe peripheral arterial occlusive disease. Osteomyelitis developed from diabetic foot ulcers in 28 patients.

--Total flap failure was noted in six patients, and osteomyelitis recurrence was noted in eight patients, for which two patients underwent amputation surgery during the follow-up period.

--Only end-stage renal disease had a significant correlation with the recurrence rate. There was no significant relationship between outcomes and the other factors.

Finally, this study found that free flaps might be utilized safely to treat osteomyelitis in patients with comorbidities and those with osteomyelitis caused by diabetic foot ulcers. Patients with end-stage renal disease should be treated with caution.