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Introduction: Tibial osteomyelitis is a common complication of bone tissue trauma. Obtaining good soft tissue coverage and effective infection management is key to the treatment of chronic osteomyelitis of the tibia accompanied with bone defect and bone exposure. The pedicled posterior tibial artery perforator layered fasciocutaneous flap can be used to repair soft tissue defects and can be used as a long-term, localized anti-infective., Case Report: A 54-year-old male presented with an ulcer, purulent discharge at the left anterior tibia, and a fever 28 years after complete healing of the scar site. The patient received debridement and negative pressure wound therapy (NPWT) in a hospital setting. After presenting to the authors' department, there was difficulty in closing the exposed bone marrow cavity. On the basis of systemic use of intravenous antibiotics, multiple debridements and NPWT were used to effectively remove necrotic tissue and control infection. Afterward, the pedicled posterior tibial artery perforator layered fasciocutaneous flap was designed to fill the bone marrow cavity as well as cover and seal the wound of bone exposure and soft tissue defect simultaneously. The layered fasciocutaneous flap was well established after operation, and no recurrence of osteomyelitis was found., Conclusion: Debridement with negative pressure wound therapy can be an effective treatment for the wound bed preparation in advance of surgery, and the pedicled posterior tibial artery perforator layered fasciocutaneous flap can be used for the treatment of several soft tissue defects.

Introduction: Debridement and control of wound drainage are critical for managing patients with extensive traumatic wounds because wound infection can result in sepsis and further complications., Case Report: The authors report the case of a 19-year-old woman with an extensive crush/degloving injury to her right lower limb that was treated with negative pressure wound therapy (NPWT) with a reticulated open-cell foam dressing. The patient received 2 treatments of sharp debridement and vacuum drainage using wall suction and polyvinyl alcohol dressings. Her respiratory failure, sepsis, and septic shock continued to worsen, and she could not tolerate anesthesia. On post admission day 9, after simple debridement where only superficial necrosis tissue was debrided without anesthesia, NPWT was applied for 5 days and removed about 8500 mL of exudate the first day and 6000 mL on the second. After 5 days, her wound began to improve, granulation tissue formed, no necrotic tissues were visible, and vital signs were stable. On day 14, she underwent anesthesia, surgical debridement, and application of NPWT for an additional 5 days. Following autologous skin grafting on day 19, she was removed from the ventilator (which was started on day 3). The extensive wound was effectively closed; she recovered satisfactorily. There was no patient follow-up., Conclusions: In this case, NPWT, in continuous mode at -125 mm Hg, effectively removed exudate after simple debridement in a patient who could not tolerate anesthesia.