Chronic osteomyelitis: what the surgeon needs to know.

Area of Science:

• Orthopedics
• Infectious Diseases
• Surgical Management

Background:

• Chronic osteomyelitis is a progressive inflammatory bone disease characterized by pathogen involvement, bone destruction, and sequestrum formation.
• The condition's presentation, severity, and prognosis are multifactorial, often involving periods of quiescence.
• Accurate diagnosis relies on bone cultures and histopathology, but management remains complex.

Purpose of the Study:

• To outline the diagnostic criteria for chronic osteomyelitis.
• To emphasize the necessity of a multidisciplinary approach for effective management.
• To discuss current treatment strategies, including antimicrobial and surgical interventions.

Main Methods:

• Review of diagnostic standards for chronic osteomyelitis.
• Description of a multidisciplinary team approach involving various medical specialists.
• Discussion of tailored treatment plans based on patient-specific factors.

Main Results:

• The gold standard for diagnosis includes positive bone cultures and histopathology.
• Management necessitates a collaborative effort from radiologists, infectious disease specialists, orthopedic surgeons, and plastic surgeons.
• Treatment should integrate antimicrobial therapy, surgical intervention, dead space management, and reconstruction.

Conclusions:

• Chronic osteomyelitis management is challenging and requires a personalized, multidisciplinary strategy.
• Combined antimicrobial and surgical treatment is crucial for addressing bone destruction and infection.
• Relapse is possible, significantly impacting patient quality of life and healthcare costs.