Bone Infection

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Chronic Refractory Osteomyelitis

Osteomyelitis is a bacterial infection of bone and bone marrow in which the resulting inflammation can lead to a reduction of blood supply to the bone. The infection that causes osteomyelitis often starts in another part of the body and spreads to the bone via the blood. The affected bone may have been predisposed to infection because of recent trauma. When the bone is infected, pus is produced within the bone, which may result in an abscess. The abscess then deprives the bone of its blood supply.

Chronic osteomyelitis results when bone tissue dies as a result of the lost blood supply. Chronic infection can persist intermittently for years. Risk factors are recent trauma, diabetes, hemodialysis, and intravenous drug abuse. Symptoms include pain in the bone, swelling, redness, fever, nausea, and in chronic osteomyeltis drainage of pus through the skin.

In chronic infection, surgical removal of dead bone tissue is usually necessary. The open space left by the removed bone tissue may be filled with bone graft or by packing material to promote the growth of new bone tissue. Antibiotic therapy is continued for at least three weeks after surgery. Resistant or extensive chronic osteomyelitis may result in amputation, especially in diabetics or other patients with poor blood circulation.

Osteomyelitis is deemed “refractory” when it persists and recurs after the usual treatments such as antibiotics and surgery have not worked.

Hyperbaric oxygen therapy works to lower the amputation rate in chronic refractory osteomyelitis patients by raising oxygen levels in the infected tissue to enhance healing when antibiotic treatment shows no significant healing.

Case Study

Chronic Osteomyelitis – Right Heel

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