Abstract: Objective To investigate the feasibility and efficacy of the induced membrane technique combined with chimeric anterolateral thigh perforator leaf flap to cure limb exposed infection bone a nd multiple lacunar wounds. Methods From January 2016 to June 2019,28 patients with multiple lacunar wounds of limbs and bone exposure infection after internal fixation were treated in our hospital.The original internal fixation plate was retained, and the bone defect was occupied by antibiotic-loaded bone cement. The anterolateral femoral perforating branch lobular flap was used to repair the skin defect and wound, and the exposed bone space was filled with chimeric muscle flap.The wound area was from from 4cm×6cm to 8cm×14cm.Muscle flap resection range was about 3cm×6cm to 6cm×10cm.Direct closure of donor area or skin graft.Under the condition of bone infection control, bone cement was taken out 12 weeks after operation, and peanut sized granules were prepared by autologous iliac bone and fully implanted around the induction membrane.If the amount of autologous bone is insufficient, allogeneic bone should be added to repair the bone defect． Results All the 28 cases of flaps were survival well.And 22 cases of bone infection was cured at first intention,and the bone graft was clinical healed at second intention.6 cases of bone infection was cured after the second-stage expansion operation and antibiotic-containing bone cement implantation,then the bone graft was clinical healed.All patients were followed up for 12-24 months(mean 18 months).The color and texture of all flaps were good,the muscle strength of quadriceps femoris was normal,and the activity of knee joint was not affected. Conclusion Membrane induction technology combined with anterolateral femoral perforator and lobed chimeric tissue flap can simultaneously solve multiple wounds such as bone infection and bone exposed lacunar wounds.

Key words: anterolateral thigh perforator leaf flap, chimeric flap, induced membrane technique, osteomyelitis