Reconstruction of Lower Limbs After Osteomyelitis: Surgical Approaches and Clinical Challenges

The primary objective of this study is to evaluate the efficacy of a multidisciplinary, evidence-based approach in the treatment of osteomyelitis at the Hospital de Base of the Federal District. This complex bone infection demands a comprehensive management strategy that emphasizes the eradication of the infection and the functional restoration of the affected limb. The treatment protocol integrates advanced surgical techniques, such as the use of negative pressure therapy and antibiotic-impregnated biocomposites and considers patient-specific factors like severity of infection, tissue viability, and comorbid conditions. Special attention is given to the selection between pedicled and free microvascularized flaps for soft tissue reconstruction, based on the patient’s vascular health and the presence of conditions such as diabetes and peripheral arterial disease. The efficacy of early and effective soft tissue coverage in reducing infection rates and hospitalization time is demonstrated, alongside tailored antibiotic therapy that targets specific pathogens identified through meticulous microbiological testing. Additionally, the study underscores the importance of a customized rehabilitation plan, involving physical and occupational therapy, to ensure optimal functional recovery. This protocol serves as a model for modern osteomyelitis management, combining innovative surgical and medical treatments to significantly improve patient outcomes.