The treatment of chronic osteomyelitis: a 10 year audit.
Despite modern surgical techniques and advanced antimicrobial therapy, osteomyelitis remains a difficult and challenging problem. A 10 year audit study from 1990 to 2000 was carried out to assess the outcome of treatment of chronic osteomyelitis. A total of 41 patients with chronic osteomyelitis (26 male, 15 female with an age range of 10-76 years, mean 45.3 years) underwent extirpation and reconstruction with muscle interposition. The duration of osteomyelitis ranged from 1 to 69 years (mean 16.6 years) and many patients had undergone multiple attempted procedures prior to definitive treatment. Thirty-seven patients underwent free microvascular muscle transfer and four patients underwent local transposition muscle flaps. Two of the 41 patients developed recurrent sepsis at 12 months (4.4% recurrence rate). These were treated successfully with elevation of the flap and curettage of the remaining infection and debris and re-insetting of the flap. Only one patient in the series required a below knee amputation and this was as a result of persistent intractable bone pain rather than recurrence of the osteomyelitis.
Department Plastic and Reconstructive Surgery, St James's University Hospital, Leeds LS9 7TF, UK. ian.smith165@virgin.net
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IM
Smith
O M B
OM
Austin
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Batchelor
D000293:Adolescent; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D002648:Child; D002908:Chronic Disease; D002968:Clavicle / Q000601:surgery; D005260:Female; D005269:Femur / Q000601:surgery; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation; D010019:Osteomyelitis / Q000209:etiology / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation; D013524:Surgical Flaps; D013977:Tibia / Q000601:surgery; D016896:Treatment Outcome