The use of the vastus lateralis flap in patients with intractable infection after resection arthroplasty following the use of a hip implant.

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.