Osteomyelitis (Bone Infection)
Chronic osteomyelitis is one of the few infectious diseases that probably became more common in the 20th Century than it had been in earlier times. Although antibiotics have
drastically improved the management and outcomes seen in therapy of acute osteomyelitis, they have had substantially less impact on therapy of patients with chronic osteomyelitis.
The mainstay of therapy for chronic osteomyelitis is primarily surgical with antibiotics
serving as an adjunct.
Acute vs. Chronic Osteomyelitis
||Good response to antibiotics;
limited surgery may be necessary
||Minimal response to antibiotics;
aggressive surgery often necessary
Differences in approaches to acute osteomyelitis and chronic osteomyelitis are necessary because of differences in the histopathology of the
diseased bones. Acute osteomyelitis is associated with intense inflammation, but, if treated promptly and aggressively, can be cured before the hallmark of chronic osteomyelitis
dead bone (a sequestrum) – develops.
Osteomyelitis that occurs at the site of trauma is, by definition, "chronic" from the onset, since dead bone, caused by the trauma that introduced the infection, is already
present. As such, therapy of any such osteomyelitis must be focused upon elimination of devitalized and poorly vascularized tissue (sequestra and scars) and appropriate antimicrobial
therapy. Instituting one without the other will not likely lead to a successful outcome.
One of the major obstacles to eliminating all dead, infected bone has been the necessity of preserving function. In attempting to eliminate the infection, we must strive to preserve function of the limb. However, for over 50 years now, we have
had the means to eliminate dead bone and remodel the remaining bone to fill the gap. The procedure
and the device most commonly used to accomplish this are named after Dr. Gavriil Ilizarov, the Russian physician who discovered this approach.
For more information or to make an appointment, call 860-679-6600 or 800-535-6232.
8 a.m. to 4:30 p.m.
Monday through Friday
New England Musculoskeletal Institute
Medical Arts & Research Building
UConn Health Center
263 Farmington Avenue
Farmington, CT 06030-5352
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