Osteomyelitis is an infection and inflammation of bone that can be caused by bacteria or mycobacteria. The most common treatments are surgery to remove infected or dead bone portions followed by antibiotics administered either intravenously in the hospital or orally at home. For chronic osteomyelitis, treatment often requires a combination of long-term antibiotics and additional surgeries such as removing infected tissue or bone, draining pus, or amputating the affected limb if the infection has spread. Hyperbaric oxygen therapy may help some acute or chronic cases that do not respond to usual treatments by delivering high oxygen levels to promote healing, but more evidence is still needed on its effectiveness.

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 !