Surgery

1. Osteomyelitis
Surgery Presentation

2. *Osteomyelitis(OM)isinfectionandinflammationofthebone.Itcanbesubclassifiedon
thebasisofthecausativeorganism(pyogenicbacteriaormycobacteria)andtheroute,
durationandanatomiclocationoftheinfection.Osteomyelitisusuallybeginsasanacute
infection,butitmayevolveintoachroniccondition.

3. *Themostcommontreatments forosteomyelitisaresurgerytoremoveportionsof
bonethatareinfected ordead,followedbyantibiotics.Hospitalizationisusually
necessary.

4. *Acuteosteomyelitis,ifdiagnosedquickly,canbesuccessfullytreatedusingacourseof
antibioticsforatleastfourtosixweeks.
*Forpartofthetreatmentyouwillneedtotakethemedicineintravenously(directlyintoa
vein),usuallywhileinhospital.Ifyouarewellenough,youmaybeabletoreceive
injectionsasanoutpatient,soyoucangohomethesameday.
*Afteryoursymptomsstarttoimprove,aswitchisusuallymadetoantibiotictabletsyou
cantakeathome.

5. *Incasesofosteomyelitis,thereisachoiceofantibioticsavailabletotreattheinfectionand
twoantibioticsareoftenusedincombination.Thisisknownasdualtherapy.
*Occasionally,thebacteriacausingtheinfectionareresistanttostandardantibioticsand
antibioticsthatareusedlessfrequentlyareneeded.
*Allantibioticshavesideeffects,whichshoulddiscusswithGPorthedoctorinchargeof
care.
Othermedication
*Inrarecaseswhereafungalinfectionhascausedosteomyelitis,antifungalmedicationsare
used.
*Painkillersmayalsobeusediftheconditioniscausingyoudiscomfort.

6. *Peoplewithchronicosteomyelitiswillusuallyrequireacombinationof
antibioticsandsurgery.Surgerymaybeusedtoremovebone,todrainpusfroma
woundorabscess,ortoremoveandreplaceajointreplacement ifitwasthecause
ofinfection.

7. *Dependingontheseverityoftheinfection,osteomyelitissurgerymayincludeoneormoreofthefollowingprocedures
*Draintheinfectedarea.Openinguptheareaaroundinfectedboneallowssurgeontodrainanypusorfluidthathas
accumulatedinresponsetotheinfection.
*Removediseasedboneandtissue.Inaprocedurecalleddebridement,thesurgeonremovesasmuchofthediseased
boneaspossible,andtakesasmallmarginofhealthybonetoensurethatalltheinfectedareashavebeenremoved.
Surroundingtissuethatshowssignsofinfectionalsomayberemoved.

8. * Restorebloodflowtothebone.surgeonmay fillanyempty spaceleft
bythedebridement procedurewithapieceofboneorothertissue,
suchasskinormuscle,fromanother partofbody.
* Sometimestemporary fillersareplacedinthepocketuntilpatients
healthyenoughtoundergoabonegraftortissuegraft.Thegrafthelps
patientbody repairdamaged bloodvesselsandformnewbone.
* Removeanyforeignobjects.Insomecases,foreignobjects,suchas
surgicalplatesorscrewsplacedduringaprevioussurgery,mayhaveto
beremoved.
* Amputatethelimb.Asalastresort,surgeonsmayamputatethe
affectedlimbtostoptheinfectionfromspreadingfurther.

9. * Someresearchershavearguedthatatypeofnon-surgicaltreatmentcalledhyperbaricoxygentherapymay
beusefulintreatingcasesofbothacuteandchronicosteomyelitisthatdonotrespondtoconventional
treatment.
* Duringhyperbaricoxygentherapy,youareplacedinaspeciallydesignedchamber,similartoa
decompressionchamberusedbydivers.
* Thechamberisfilledwithoxygen,administeredatamuchhigherpressure(hyperbaric)thanthenormal
levelofoxygenintheatmosphere.Thehighlevelsofoxygenarethoughttospeedupthehealingprocess
andslowthespreadofinfection.

10. *Thereiscurrentlyonlylimitedevidence
supportingtheeffectivenessofhyperbaricoxygen
therapyfortreatingosteomyelitis.Fromthe
evidenceavailable,itwouldappearitismost
effectiveintreatingosteomyelitisassociatedwitha
diabeticfootulcer.
*However,theNationalInstituteofHealthand
CareExcellence(NICE)recommendthatoxygen
therapyshouldonlybeusedtotreatdiabeticfoot
ulcersaspartofaclinicaltrial.

11. Thank You !