[Autologous blood-antibiotic filling as effective therapy of chronic osteomyelitis]

A control of osteomyelitis by parenteral administration of antibiotic drugs is not possible due to sequestration, thrombosis of the peripheral vessels, and encapsulation of the osseous focuses. The autoblood-antibiotic plombage was indicated in 1951 by Winter. The principle used for this method is the concentration of one or more antibiotic drugs in an autogenic carrier releasing the drugs which then exert their effect directly at the site of the disease. In the experimentation on animals, the streptomycin level in the peripheral blood decreases only after 130 hours to the inhibiting threshold value of 0.008 g/ml. The autoblood-antibiotic filling becomes a connective tissue filling and, about seven weeks later, a bone filling. There are three conditions for a therapeutic success of the antibiotic plombage. 1. It must be only a limited, unilocalized, not too extended bone process. 2. large débridement and sequestrotomy, and 3. the bone must be provided with an own absolute stability. 74 out of 112 patients treated with an autoblood-antibiotic plombage were immediately free from symptoms. Two thirds of these patients showed a superficial recovery.