Recurrent sepsis and breakdown of the tissues in the operative wound
after resection arthroplasty is performed for a hip with an infection at
the site of an implant present a formidable challenge. A review of the
literature indicates that more than 25 per cent of patients had delayed
healing, additional surgery, or persistent drainage after resection
arthroplasty. Under these circumstances, muscle flaps may help provide
definitive closure, cessation of drainage, and functional recovery of the
extremity as well as a reduction in the length and cost of hospitalization.
The successful use of a vastus lateralis flap in seven patients is
described. The specific advantages are: the flap has a consistent reliably
identified vascular pedicle which permits a wide arc of rotation;
sufficient muscle volume enables large open wounds to be filled; the
structural integrity of the muscle is not violated by previous operations;
and no important functional deficit is attributable to the procedure.