Soft-Tissue Reconstruction

Soft-tissue reconstruction is crucial to treat fracture-related infection (FRI) 1,2 , periprosthetic joint infection (PJI) 3 , diabetic foot syndrome (DFS) and pressure injuries 4 successfully. The orthoplastic treatment concept includes the preoperative three dimensional analysis of the soft-tissue defect, the functional deficit (e.g. the extensor apparatus of the knee) 5 , the types of tissue missing (skin, hypodermis, tendon, extensor apparatus, nerves) and the principle to reconstruct missing tissue ‘like with like’. In addition to the functional aspect of the reconstruction, the soft tissue envelope does not only prevent new infection, but also acts as a vehicle for the transport of nutrients and antimicrobial agents to the site of infection. In all these scenarios a multidisciplinary strategy, including a thoroughly planned orthoplastic approach - is imperative. The lack of an orthoplastic concept may lead to further soft-tissue damage with bone stock loss and, eventually, to limb amputation.