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Surgical management of chronic osteomyelitis:Organisms,recurrence and treatment outcome

Chinese Journal of Traumatology 2023年第4期26卷 228-235页

作者： Koushik Narayan Subramanyam Abhishek Vasant Mundargi Milind Vittal Prabhu K.U.Gopakumar D.S.Ankush Gowd devagiri raviteja reddy Department of Orthopaedics Sri Sathya Sai Institute of Higher Medical Sciences-PrasanthigramPuttaparthiAndhra Pradesh515134India School of Liberal Arts Indian Institute of TechnologyJodhpurRajasthan342001India

Purpose:The study aimed to identify the risk factors of recurrence in chronic osteomyelitis(COM)and to document the microbiological patterns pre-and intra-operatively and at recurrence,if ***:We performed retrospective review on COM patients treated with surgical debridement and a 6-week course of *** patients with symptoms of osteomyelitis for at least 6 weeks,present or past episodes of discharging sinus,documentation of bone sequestration in operative notes or preop-erative images were included in the *** with symptoms of osteomyelitis<6 weeks,lack of history of discharging sinus or lack of evidence of sequestration in preoperative images or intraoperative notes were *** regression models were used to assess the impact of risk factors of ***-Kappa scores were derived to see the concordance between pre-operative and intra-operative isolates and at ***:Totally,147 COM patients(115 males and 32 females,mean age(33±19)years)were included in this *** was noted in 28 patients(19.0%).Polymicrobial growth and extended spectrum beta-lactamase producing Enterobacteriaceae increased the chance of ***-Mader stage-1,hematogenous aetiology and negative intraoperative culture reduced the chance of *** between pre-operative and intra-operative cultures was 59.85%(Kappa score 0.526,p<0.001)and between index surgery and at recurrence was 23.81%(Kappa score 0.155,p<0.001).Lack of knowledge of causative organism preoperatively did not affect *** mean follow-up(42±15)months,all patients were apparently infection free for at least 1 ***:Polymicrobial growth and multi-drug resistant organisms increase the risk of recurrence in ***'age,gender,diabetes mellitus,previous failed treatment,duration of symptoms,hae-moglobin,white cell count,C-reactive protein and erythrocyte sedimentation rate at presentation did not have any impact on the recurre

关键词： Chronic osteomyelitis Debridement Antibiotics Osteomyelitis recurrence Osteomyelitis relapse

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