| Abstrakt: |
Aim: Non-healing wounds are characterized by a high socio-medical impact, with a prevalence of up to 5% after the age of 65, a high rate of non-healing (20% at two years) and a very high rate of recurrences (67%). The purpose of this study is to demonstrate how microsurgery can be a valid therapeutic option in carefully selected patients, guaranteeing complete time-effective healing and functional recovery. Method: Patients were selected on the basis of election criteria, such as the absence of granulation/healing signs after adequate debridement and conservative treatment, no relevant comorbidities, good compliance, restoration of a pre-existing function. All patients underwent accurate instrumental diagnostic classification through Echo-color Doppler, TcPO2, CT Angiogram, deep sampling with consequent targeted antibiotic therapy in presence of signs of local infection, angiography in view of the need for revascularization. Results / Discussion: Patients with non-healing wounds from various aetiologies such as diabetic foot, chronic osteomyelitis, complicated traumatic wounds, surgical dehiscences with exposure of fixation devices were included in the study. The parameters of choice for the most suitable flap were good vascularisation to guarantees adequate blood flow, thickness that allows the use of footwear, load and traction resistance. In all cases treated with microsurgical reconstruction, complete healing was obtained, with restoration of functionality and no recurrence. In no case was there any loss of the free flap. Conclusion: In the treatment of non-healing wounds microsurgery represents the final phase of a broader path, which is in fact based on a multidisciplinary step by step approach that starts from an accurate general classification of the patient, wound preparation, careful surgical planning, patient education and follow up. [ABSTRACT FROM AUTHOR] |
