The septic complications after hip arthroplasty are extremely severe due to frequent chronicity and prosthesis looseness, despite the expensive long-term antibiotic treatment. Starting from the well-know function of the greater omentum to isolate any septic intraperitoneal processes (an "extended lymph node"), we initiated a surgical technique which uses the greater omentum in the treatment of septic complications after hip surgery.
The technique consist in mobilisation of the greater omentum along the right or left gastroepiploic artery according to the affected hip, and placing it in the septic area after passing it anterior or posterior of the inguinal ligament. Between 1997 and 2004 we performed this technique on 5 patients (4 men and 1 woman) with ages ranking between 24 and 47, which presented chronic infections after hip arthroplasty (4 cases) and after iliac bone resection-reconstruction for fibrosarcoma (1 case).
The post-operatory evolution was favourable in all cases. In one case the local septic process pursued demanding a reintervention that revealed that the great omentum has been retracted from the hip area. In 4 cases the septic processes has withdraw spectacularly.
The use of the greater omentum in the treatment of septic complications after hip and pelvic surgery represents in some cases the only effective solution. This technique requires a good collaboration between orthopaedic and general surgeons.