this is a infectious condition of bone and for b.bsc. and gnm students for their refrence for the care of patients in bone disorder this topic includes its definition, etiology, pathophysiology, clinical menistification, diagnostic evaluation and its management

2. LEARNING OBJECTIVES
At the end of this class the students must be
able to
1. Define Osteomylitis.
2. Enlist etiology & risk factors of Osteomylitis.
3. Explain the pathophysiology Osteomylitis.
4. Enlist the clinical manifestation of Osteomylitis.
5. Enumerate diagnostic findings of Osteomylitis.

3. 6. Explain the pharmacological therapy of
Osteomylitis.
7. Describe the surgical management .
8. Enumerate nursing diagnosis for Osteomylitis.
9explain the preventive measure of Osteomylitis.
Ct---LEARNING OBJECTIVES

4. DEFINITION
Osteomylitis is a severe pyogenic infection of
bone & surrounding tissues that requires
immediate treatment.
Generally there are 3 routes.
1. Blood stream (heamatogenous spread).
2. Adjacent soft tissue infection (contagious focus).
3. Direct introduction of microorganisms into the
bone.

7. ETIOLOGY
1. Direct inoculation- penetrating trauma leads to
acute Osteomylitis.
2. Contagious spread – pseudomonas
aeruginosa, staphylococcus & proteus.
3. Heamatogenous spread – bacteremia, non
penetrating trauma, long term I.V. catheters

8. TYPES
1. In acute condition lasting less than 4 weeks.
2. Chronic condition more than 4 weeks.

9. PATHOPHYSIOLOGY
 Due to the causes
 Invasion of the bacteria into bone & surrounding soft
tissues & multiply
 Inflammation occurs & collection of pus
 Increase of pressure

10.  Decreased blood flow
 Bone tissue becomes necrotic which retards healing
& causes more infection often as bone abscess.

11. CLINICAL MANIFESTATIONS
 Fever
 Local signs of inflammation such as
tenderness, redness, heat, pain & swelling.
 Ulceration & drainage.

12. DIAGNOSTIC EVALUATION
1. History collection.
2. Physical examination
3. Blood investigation – CBC, ESR.
4. Aerobic & anaerobic cultures of bone tissue to
identify the organism.
5. Radiographic evidence of Osteomylitis.
6. radionuclide bone scan used to diagnose
yearly acute Osteomylitis.
7. MRI

13. MANAGEMENT
 Medical management:
1. Long term antibiotic therapy is the treatment of
choice for patient.
2. Infection in the bone tissue is difficult to resolve
& may require weeks to months of medications
like penicillin, beta lactamase agents,
tetracycline, cephalosporin, amino glycosides.

14. Ct---MANAGEMENT
 Surgical management:
1. Needle aspiration or biopsy.
2. Surgical decompression considered when
patient does not improve after 36 to 48 hours of
antimicrobial therapy.
3. Debridement may be done or antibiotic
impregnated beads used in wound (removed
after 2 to 4 weeks & replaced with bone graft).

15. Ct---Management
 Nursing management:
1. Obtain detail history.
2. Assess pain & functional deficit.
3. Be aware that systemic symptoms are acute in
children but vary in intensity with adults.
4. Performs general systemic assessment
because adults with long bone involvement
generally have more systemic septic symptoms

16. COMPLICATIONS
1. Nonhealing wound.
2. Sepsis.
3. Immobility.
4. Amputation.

17. SUMMARY
In this class we discussed the :-
1. Definition of osteomylitis.
2. Etiology & risk factors of osteomylitis.
3. Pathophysiology osteomylitis.
4. Clinical manifestation of osteomylitis.
5. Diagnostic findings of osteomylitis.

18. BIBLIOGRAPHY
Lippincott “Medical surgical nursing” 10th
edition
Joyce M Black ” Medical surgical nursing”
Brunner And Suddharth “Medical surgical
nursing”

19. THANK YOU