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Hyperbaric oxygen and chronic osteomyelitis.

B F Morrey, J M Dunn, R D Heimbach

    Clinical Orthopaedics and Related Research
    |October 1, 1979
    PubMed
    Summary
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    Hyperbaric oxygen therapy, combined with surgery and antibiotics, shows promising results for chronic osteomyelitis, with a 15% recurrence rate. Effective treatment appears linked to adequate surgical management, especially for difficult cases.

    Area of Science:

    • Orthopedics
    • Infectious Diseases
    • Hyperbaric Medicine

    Background:

    • Chronic osteomyelitis is a challenging infection, often requiring aggressive treatment.
    • Patients frequently present with refractory infections, poor prognoses, and limited treatment options.

    Purpose of the Study:

    • To evaluate the efficacy of hyperbaric oxygen therapy as an adjunct to standard treatment for chronic osteomyelitis.
    • To explore the potential mechanisms of action and factors influencing recurrence rates.

    Main Methods:

    • A cohort of 40 patients with chronic osteomyelitis received hyperbaric oxygen therapy alongside surgical intervention and antibiotics.
    • Patients were followed for an average of 2 years to assess treatment outcomes and recurrence.

    Main Results:

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    • A recurrence rate of 15% was observed in the treated group.
    • Recurrence was primarily associated with inadequate surgical management, not infection site or pathogen.
    • Hyperbaric oxygen likely enhances local vascularity and phagocytosis, indirectly aiding treatment.

    Conclusions:

    • Hyperbaric oxygen therapy is an encouraging adjunct for managing refractory chronic osteomyelitis.
    • It may be particularly beneficial for patients where amputation is being considered.
    • Optimal surgical and medical management remains crucial for successful outcomes.