Update on management of chronic osteomyelitis: report of four cases.

Pessimism has existed concerning the cure of patients with chronic osteomyelitis. This has been based on the lack of complete bone and soft tissue debridement in the face of inability to completely cover the resultant wound with adequately perfused tissue. Regional and distant tissue transfers, allow freedom of debridement based on tissue viability rather than on amount of local tissue available to close the wound. Four cases in which regional and distant flaps were used to close defects created after debridement are presented. An overview of reconstruction of such defects is discussed. It is concluded that early management of compound fractures particularly those that require reconstruction will prevent the development of chronic osteomyelitis and thereby undue morbidity.