title: Surgical Debridement Is Superior to Sole Antibiotic Therapy in a Novel Murine Posttraumatic Osteomyelitis Model.
abstract: BACKGROUND
  Bone infections after trauma, i.e. posttraumatic osteomyelitis, pose one of the biggest problems of orthopedic surgery. Even after sufficient clinical therapy including vast debridement of infected bone and antibiotic treatment, regeneration of postinfectious bone seems to be restricted. One explanation includes the large sized defects resulting from sufficient debridement. Furthermore, it remains unclear if inflammatory processes after bone infection do affect bone regeneration. For continuing studies in this field, an animal model is needed where bone regeneration after sufficient treatment can be studied in detail.
  
  
  METHODS
  For this purpose we created a stable infection in murine tibiae by Staphylococcus aureus inoculation. Thereafter, osteomyelitic bones were debrided thoroughly and animals were subsequently treated with antibiotics. Controls included debrided, non-infected, as well as infected animals exclusively treated with antibiotics. To verify sufficient treatment of infected bone, different assessments detecting S. aureus were utilized: agar plates, histology and RT-qPCR.
  
  
  RESULTS
  All three detection methods revealed massive reduction or eradication of S. aureus within debrided bones 1 and 2 weeks postoperatively, whereas sole antibiotic therapy could not provide sufficient treatment of osteomyelitic bones. Debrided, previously infected bones showed significantly decreased bone formation, compared to debrided, non-infected controls.
  
  
  CONCLUSIONS
  Thus, the animal model presented herein provides a reliable and fascinating tool to study posttraumatic osteomyelitis for clinical therapies.
authors.affiliation: Department of Plastic Surgery, BG Bergmannsheil Bochum, Ruhr-University of Bochum, Bochum, Germany.
authors.forename: Johannes Maximilian
authors.initials: JM
authors.lastname: Wagner
authors.affiliation: Department of Plastic Surgery, BG Bergmannsheil Bochum, Ruhr-University of Bochum, Bochum, Germany.
authors.forename: Hannah
authors.initials: H
authors.lastname: Zöllner
authors.affiliation: Department of Plastic Surgery, BG Bergmannsheil Bochum, Ruhr-University of Bochum, Bochum, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Wallner
authors.affiliation: Department of Plastic Surgery, BG Bergmannsheil Bochum, Ruhr-University of Bochum, Bochum, Germany.
authors.forename: Britta
authors.initials: B
authors.lastname: Ismer
authors.affiliation: Department of Plastic Surgery, BG Bergmannsheil Bochum, Ruhr-University of Bochum, Bochum, Germany.
authors.forename: Jessica
authors.initials: J
authors.lastname: Schira
authors.affiliation: Department of Plastic Surgery, BG Bergmannsheil Bochum, Ruhr-University of Bochum, Bochum, Germany.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Abraham
authors.affiliation: Department of Plastic Surgery, BG Bergmannsheil Bochum, Ruhr-University of Bochum, Bochum, Germany.
authors.forename: Kamran
authors.initials: K
authors.lastname: Harati
authors.affiliation: Department of Plastic Surgery, BG Bergmannsheil Bochum, Ruhr-University of Bochum, Bochum, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Lehnhardt
authors.affiliation: Department of Plastic Surgery, BG Bergmannsheil Bochum, Ruhr-University of Bochum, Bochum, Germany.
authors.forename: Björn
authors.initials: B
authors.lastname: Behr
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003646:Debridement; D004195:Disease Models, Animal; D005260:Female; D008297:Male; D008810:Mice, Inbred C57BL; D010019:Osteomyelitis / Q000150:complications / Q000188:drug therapy* / Q000601:surgery*; D013203:Staphylococcal Infections / Q000150:complications / Q000188:drug therapy* / Q000601:surgery*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D013977:Tibia / Q000293:injuries* / Q000382:microbiology / Q000601:surgery*
chemical_list: D000900:Anti-Bacterial Agents