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[Treatment of acute hematogenous osteomyelitis in children]
Insights
Early diagnosis and emergency surgery are crucial for treating acute hematogenic osteomyelitis in children. Intensive, complex treatment, including multi-stage antibiotic therapy, significantly improves outcomes and reduces mortality.
Area of Science:
- Pediatric Infectious Diseases
- Orthopedic Surgery
Context:
- Acute hematogenic osteomyelitis affects children aged 1-15 years.
- Treatment outcomes depend on timely diagnosis and intervention.
Purpose:
- To analyze the treatment experience of 348 children with acute hematogenic osteomyelitis.
- To evaluate the effectiveness of intensive, complex treatment strategies.
Summary:
- Early diagnosis and emergency surgical decompression, debridement, and antibiotic delivery to the focus are critical.
- Preoperative management for severe cases includes detoxification and hemodynamic stabilization.
- A three-stage antibiotic regimen, including intravenous, intramuscular, and intraosseous administration, is detailed.
- Intraosseous injections were used daily for newborns and infants during the initial treatment phase.
Impact:
- Intensive and complex measures applied timely and urgently improve treatment results.
- Mortality rates decreased from 1.7% over a decade to 0.8% in the last two years, demonstrating treatment efficacy.
Abstract:
Experience in treatment of 348 children with acute hematogenic osteomyelitis is analysed. Newborn infants and children whose ages ranged from 1 to 15 years formed a group of patients. Of decisive importance in the outcome of the disease are early diagnosis and emergency operative measures, aimed at decompressing, opening and cleansing the purulent foci, producing a high concentration of antibiotics in the focus. Children who are in a grave condition are subjected to short-term preoperative management for 3-4 hours for detoxification, improvement of hemodynamics, prevention of septic shock and hyperthermia. Antibiotic therapy is given in 3 stages: in the first 10 days no less than 3 antibiotics are injected into the veins, into the muscles, and into the bones; from days 11 to 20 2 antibiotics are injected intramuscularly or into the bone; in the next 10 days one antibiotic is administered into the bone or muscle. Newborns and infants received injections by daily intraosseous puncture during the first 8-10 days of treatment. It is shown that the results of treatment may be improved only by intensive and complex measures applied timely and urgently. The mortality rate was 1.7% for the decade and 0.8% for the last 2 years.