Articles | Volume 10, issue 6
https://doi.org/10.5194/jbji-10-597-2025
© Author(s) 2025. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
https://doi.org/10.5194/jbji-10-597-2025
© Author(s) 2025. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
A human-scale porcine fasciocutaneous and muscle flap model for the evaluation of ortho-plastic reconstructions of lower-limb defects
Josefine Slater
CORRESPONDING AUTHOR
Aarhus Denmark Microdialysis Research (ADMIRE), Orthopaedic Research Laboratory, Aarhus University Hospital, Aarhus, 8200, Denmark
Department of Clinical Medicine, Aarhus University, Aarhus, 8200, Denmark
Maiken Stilling
Aarhus Denmark Microdialysis Research (ADMIRE), Orthopaedic Research Laboratory, Aarhus University Hospital, Aarhus, 8200, Denmark
Department of Clinical Medicine, Aarhus University, Aarhus, 8200, Denmark
Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, 8200, Denmark
Andreas Engel Krag
Aarhus Denmark Microdialysis Research (ADMIRE), Orthopaedic Research Laboratory, Aarhus University Hospital, Aarhus, 8200, Denmark
Department of Clinical Medicine, Aarhus University, Aarhus, 8200, Denmark
Department of Plastic and Breast Surgery, Aarhus University Hospital, Aarhus, 8200, Denmark
Sara Kousgaard Tøstesen
Aarhus Denmark Microdialysis Research (ADMIRE), Orthopaedic Research Laboratory, Aarhus University Hospital, Aarhus, 8200, Denmark
Department of Clinical Medicine, Aarhus University, Aarhus, 8200, Denmark
Mads Kristian Duborg Mikkelsen
Aarhus Denmark Microdialysis Research (ADMIRE), Orthopaedic Research Laboratory, Aarhus University Hospital, Aarhus, 8200, Denmark
Department of Clinical Medicine, Aarhus University, Aarhus, 8200, Denmark
Martin McNally
Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospital, Oxford, OX3 7LD, United Kingdom
Alexander James Ramsden
Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospital, Oxford, OX3 7LD, United Kingdom
Louise Kruse Jensen
Department of Veterinary Animal Sciences, University of Copenhagen, Frederiksberg, Denmark
Birgitte Jul Kiil
Department of Plastic and Breast Surgery, Aarhus University Hospital, Aarhus, 8200, Denmark
Aarhus Denmark Microdialysis Research (ADMIRE), Orthopaedic Research Laboratory, Aarhus University Hospital, Aarhus, 8200, Denmark
Department of Clinical Medicine, Aarhus University, Aarhus, 8200, Denmark
Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, 8200, Denmark
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In order to monitor pin site infections, facilitate communication between team members, and assist treatment decision-making, we aimed to develop a registration tool. The present pilot study evaluates the feasibility of a prospective registration procedure for reporting, evaluating, and monitoring of pin site infections in 39 trauma, limb deformity, and bone infection patients with external ring fixation.
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To evaluate bone and tissue concentrations following intraosseous vancomycin administration, eight pigs were injected with 500 mg vancomycin into the tibia followed by a 12 h sampling period. This provided high concentrations in the tibia bone nearby the injection site the entire period, though with a wide range of peak concentration. The systemic absorption was high and immediate, thus mirroring an intravenous administration. Low mean concentrations were found in adjacent tissue compartments.
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Chronic bone infections often present with major bone and soft tissue loss which can be difficult to manage. In this study, we treated the most complex infections using surgery which reconstructed all of the tissues in one operation.
We showed that this was a safe approach with very good outcomes. All of the bones healed and 96.5 % of patients were infection-free at final follow-up. This type of surgery requires close cooperation of a multidisciplinary team with expertise in major infections.
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Short summary
We developed a pig model to study how different tissue flaps support the healing microenvironment of lower-leg composite defects. By measuring tissue metabolism and examining tissue samples under the microscope, we found distinct early responses between muscle and fascia-based flaps. This model may help researchers and clinicians better understand the healing of complex bone and soft-tissue defects and may provide a platform for evaluating clinically relevant ortho-plastic outcomes.
We developed a pig model to study how different tissue flaps support the healing...