Chronic Osteomyelitis
Refractory Osteomyelitis
Chronic Bone Infection
Chronic refractory osteomyelitis is an infection of bone which has
persisted or recurred after an intial course of treatment for
osteomyelitis.
The factor that frequently makes chronic osteomyelitis difficult to
cure is impaired blood flow at the site of infection. Impaired blood
flow can be the result of previous trauma, multiple surgeries,
retained hardware, underlying chronic disease (i.e. diabetes,
peripheral vascular disease, etc.) This often results in low levels
of oxygen at the bone infection site. The combination of infection
and low levels of oxygen can result in the development of dead bone
and/or scar tissue which interfere with the body's responses for
dealing with the infection as well as the delivery of antibiotics to
the site of infection.
Additionally, the body's specialized cells used for removing
infected/dead bone and replacing with healthy bone is dependent on
oxygen. Low levels of oxygen at the site of infection make these
cells function poorly as well and interferes with bone remodelling.
Evaluation of chronic refractory osteomyelitis starts with
confirmation of the diagnosis and establishment of the bacterial
organism(s) causing the infection. The diagnosis is confirmed by
history, examination and imaging studies. Once the diagnosis of
chronic osteomyelitis is confirmed a treatment plan is formulated
which often includes hyperbaric oxygen therapy, antibiotics and
likely surgical intervention to remove infected bone or hardware (if
necessary).
The overwhelming majority of published data support hyperbaric
oxygen therapy use as safe and effective when incorporated into a
comprehensive treatement plan. When used appropriately, hyperbaric
oxygen therapy can reduce the total need for surgical procedures and
required antibiotic therapy.
Additional indications for hyperbaric oxygen therapy may be
discussed with your doctor and the Hyperbaric Medicine Team.
Hyperbaric oxygen therapy is most frequently used with additional
care the patient is receiving. Additional treatments may also
include antibiotic therapy, nutritional support and surgical
procedures, if indicated. Our Hyperbaric Medicine Team will work
closely with your physician(s) to coordinate any additional care
needed.
