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Osteomyelitis
1.
Osteomyelitis Surgery Presentation
2.
*Osteomyelitis(OM)isinfectionandinflammationofthebone.Itcanbesubclassifiedon thebasisofthecausativeorganism(pyogenicbacteriaormycobacteria)andtheroute, durationandanatomiclocationoftheinfection.Osteomyelitisusuallybeginsasanacute infection,butitmayevolveintoachroniccondition.
3.
*Themostcommontreatments forosteomyelitisaresurgerytoremoveportionsof bonethatareinfected ordead,followedbyantibiotics.Hospitalizationisusually necessary.
4.
*Acuteosteomyelitis,ifdiagnosedquickly,canbesuccessfullytreatedusingacourseof antibioticsforatleastfourtosixweeks. *Forpartofthetreatmentyouwillneedtotakethemedicineintravenously(directlyintoa vein),usuallywhileinhospital.Ifyouarewellenough,youmaybeabletoreceive injectionsasanoutpatient,soyoucangohomethesameday. *Afteryoursymptomsstarttoimprove,aswitchisusuallymadetoantibiotictabletsyou cantakeathome.
5.
*Incasesofosteomyelitis,thereisachoiceofantibioticsavailabletotreattheinfectionand twoantibioticsareoftenusedincombination.Thisisknownasdualtherapy. *Occasionally,thebacteriacausingtheinfectionareresistanttostandardantibioticsand antibioticsthatareusedlessfrequentlyareneeded. *Allantibioticshavesideeffects,whichshoulddiscusswithGPorthedoctorinchargeof care. Othermedication *Inrarecaseswhereafungalinfectionhascausedosteomyelitis,antifungalmedicationsare used. *Painkillersmayalsobeusediftheconditioniscausingyoudiscomfort.
6.
*Peoplewithchronicosteomyelitiswillusuallyrequireacombinationof antibioticsandsurgery.Surgerymaybeusedtoremovebone,todrainpusfroma woundorabscess,ortoremoveandreplaceajointreplacement ifitwasthecause ofinfection.
7.
*Dependingontheseverityoftheinfection,osteomyelitissurgerymayincludeoneormoreofthefollowingprocedures *Draintheinfectedarea.Openinguptheareaaroundinfectedboneallowssurgeontodrainanypusorfluidthathas accumulatedinresponsetotheinfection. *Removediseasedboneandtissue.Inaprocedurecalleddebridement,thesurgeonremovesasmuchofthediseased boneaspossible,andtakesasmallmarginofhealthybonetoensurethatalltheinfectedareashavebeenremoved. Surroundingtissuethatshowssignsofinfectionalsomayberemoved.
8.
* Restorebloodflowtothebone.surgeonmay fillanyempty
spaceleft bythedebridement procedurewithapieceofboneorothertissue, suchasskinormuscle,fromanother partofbody. * Sometimestemporary fillersareplacedinthepocketuntilpatients healthyenoughtoundergoabonegraftortissuegraft.Thegrafthelps patientbody repairdamaged bloodvesselsandformnewbone. * Removeanyforeignobjects.Insomecases,foreignobjects,suchas surgicalplatesorscrewsplacedduringaprevioussurgery,mayhaveto beremoved. * Amputatethelimb.Asalastresort,surgeonsmayamputatethe affectedlimbtostoptheinfectionfromspreadingfurther.
9.
* Someresearchershavearguedthatatypeofnon-surgicaltreatmentcalledhyperbaricoxygentherapymay beusefulintreatingcasesofbothacuteandchronicosteomyelitisthatdonotrespondtoconventional treatment. * Duringhyperbaricoxygentherapy,youareplacedinaspeciallydesignedchamber,similartoa decompressionchamberusedbydivers. *
Thechamberisfilledwithoxygen,administeredatamuchhigherpressure(hyperbaric)thanthenormal levelofoxygenintheatmosphere.Thehighlevelsofoxygenarethoughttospeedupthehealingprocess andslowthespreadofinfection.
10.
*Thereiscurrentlyonlylimitedevidence supportingtheeffectivenessofhyperbaricoxygen therapyfortreatingosteomyelitis.Fromthe evidenceavailable,itwouldappearitismost effectiveintreatingosteomyelitisassociatedwitha diabeticfootulcer. *However,theNationalInstituteofHealthand CareExcellence(NICE)recommendthatoxygen therapyshouldonlybeusedtotreatdiabeticfoot ulcersaspartofaclinicaltrial.
11.
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