Advertisement for orthosearch.org.uk
Results 1 - 2 of 2
Results per page:
Orthopaedic Proceedings
Vol. 97-B, Issue SUPP_5 | Pages 9 - 9
1 May 2015
Chaturvedi A Barlow G Sharma HK
Full Access

Background:

– A multidisciplinary approach is essential to treat chronic osteomyelitis. Surgical debridement of macroscopic infection precedes targeted antibiotics to eradicate microscopic infection. This study analyses early results of our single-stage protocol for chronic osteomyelitis using antibiotic-impregnated calcium sulphate beads (Stimulan).

Methods:

– We retrospectively analysed patients with primary or secondary chronic osteomyelitis treated with Stimulan. Patients with incomplete metal-work removal or follow up less than 3 months were excluded. Our study focused on 15 patients (10 male) with an average age of 40.5 years (16–73 years), average follow up of 10.6 months (3 – 21 months). There were 12 cases of secondary osteomyelitis (3 primary). Majority of cases involved the tibia, femur or humerus. Following debridement Stimulan mixed with Vancomycin and/or tobramycin was placed to obliterate dead space and deliver local antibiotics. Intravenous antibiotics, typically piperacillin/tazobactam and/or teicoplanin, were administered post-operatively until tissue culture results were known – rationalised long term antibiotic regimen followed thereafter.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 495 - 495
1 Sep 2012
Singh J Marwah S Mustafa J Platt A Barlow G Raghuraman N Sharma H
Full Access

AIM

Chronic osteomyelitis still remains challenging and expensive to treat inspite of advances in antibiotics and operative techniques.

We present our experience with free muscle flap after radical debridement of chronic osteomyelitis, performed as a single stage procedure.

METHODS

We retrospectively identified eight patients (5 Females) with mean age of 63 yrs (Range40–71 yrs) Case notes were reviewed for co morbidities, Pre and post treatment inflammatory markers (plasma viscosity and CRP) and clinical staging.

Mean follow up was 3 yrs (Range 1–6 yrs) All the patients were jointly operated by orthopaedic and plastic surgeons and underwent thorough debridement and muscle flap (Seven free flaps and one rotational flap) in the same sitting. All the patients were reviewed regularly by plastic and orthopaedic surgeons.

Seven patients had free Gracilis flap and one had Triceps flap.

Clinical assessment of reinfection was made on presence of erythema, wound discharge, pain and swelling. Primary outcome measure was resolution of infection.