Treatment of deep infections of the shoulder with pedicled myocutaneous flaps

Infection after reconstruction of the shoulder can lead to significant morbidity and possible destruction of the glenohumeral joint. Often, seemingly small wound problems mask underlying soft-tissue deficiency and instability. We have reviewed our experience with deep infections of the shoulder that have been treated with pedicled myocutaneous flaps. Patients in this series had been treated by a variety of local measures including debridement and attempts at reclosure, often unsuccessfully. The ability to import well-vascularized tissue that can treat dead space as well as reestablish a new cutaneous envelope around the shoulder is desirable and indicated for these difficult cases. Surprisingly, even with exposure of the humeral head in the wound, the shoulder joint can be salvaged by use of the techniques described in this article.