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Optimal management of chronic osteomyelitis: current perspectives

Authors Pande K

Received 25 May 2015

Accepted for publication 14 July 2015

Published 31 August 2015 Volume 2015:7 Pages 71—81

DOI https://doi.org/10.2147/ORR.S50753

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Jiabing Fan

Peer reviewer comments 3

Editor who approved publication: Professor Clark Hung


Ketan C Pande

Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan, Brunei

Abstract: Chronic osteomyelitis is a challenging condition to treat. It is seen mostly after open fractures or in implant-related infections following treatment of fractures and prosthetic joint replacements. Recurrence of infection is well known, and successful treatment requires a multidisciplinary team approach with surgical debridement and appropriate antimicrobial therapy as the cornerstone of treatment. Staging of the disease and identification of the causative microorganism is essential before initiation of treatment. Important surgical steps include radical debridement of necrotic and devitalized tissue, removal of implants, management of resultant dead space, soft-tissue coverage, and skeletal stabilization or management of skeletal defects. The route of administration and duration of antimicrobial therapy continues to be debated. The role of biofilm is now clearly established in the chronicity of bone infection, and newer modalities are being developed to address various issues related to biofilm formation. The present review addresses various aspects of chronic osteomyelitis of long bones seen in adults, with a review of recent developments.

Keywords: osteomyelitis, infection, biofilm, bone, therapy, treatment

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