Show Summary Details
Page of

Infection, Amputation, and Prostheses 

Infection, Amputation, and Prostheses
Page of

PRINTED FROM OXFORD MEDICINE ONLINE ( © Oxford University Press, 2022. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice).

date: 28 June 2022

Pathological features of chronic osteomyelitis

Necrotic bone

Compromised soft tissues with reduction in vascularity

Ineffective host response

Sequestrum formation

New bone formation from viable periosteum and endosteum

Formation of involucrum:

Treatment principles in chronic osteomyelitis

Surgical debridement – remove all devitalized necrotic tissue

Dead space management:

Soft tissue defect – avoid healing by secondary intention. Consider local and free flaps

Bone defects – small structural with autologous bone graft, consider Papineau ‘open bone grafting’ where free tissue transfer is not an option, distraction osteogenesis with bifocal and bone transport for large defects including fibula transfer

Bone stability – movement needs to be eliminated

Antibiotic therapy – based on culture and sensitivity, local administration with PMMA beads or collagen sponge, Lautenbach procedure in resistant cases.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.