Osteomyelitis: treatment concepts from the plastic surgeon's point of view

Despite promising advances in antibiotic and surgical therapy osteomyelitis remians a severe disease with a high morbidity. Nowadays it occurs mainly after traumata. Typical clinical manifestations are signs of local infection, non-healing wounds, pathological fractures or loosening of orthopedic im...

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Bibliographic Details
Published inChirurg Vol. 84; no. 11; p. 962
Main Authors Horch, R E, Taeger, C D, Steinau, H U, Kneser, U, Schnürer, S
Format Journal Article
LanguageGerman
Published Germany 01.11.2013
Subjects
Chronic Disease
Combined Modality Therapy
Cooperative Behavior
Diagnostic Imaging
Free Tissue Flaps - surgery
Humans
Interdisciplinary Communication
Microsurgery - methods
Osteomyelitis - diagnosis
Osteomyelitis - pathology
Osteomyelitis - therapy
Postoperative Complications - pathology
Postoperative Complications - therapy
Reconstructive Surgical Procedures - methods
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Summary:Despite promising advances in antibiotic and surgical therapy osteomyelitis remians a severe disease with a high morbidity. Nowadays it occurs mainly after traumata. Typical clinical manifestations are signs of local infection, non-healing wounds, pathological fractures or loosening of orthopedic implants. Besides the clinical judgement the diagnosis is consolidated by imaging procedures, histopathological and microbiological examinations. Ideally, the treatment plan is based on an interdisciplinary approach. Besides the radical surgical debridement a test appropriate antibiotic therapy is essential. Defect reconstruction after surgical debridement and optimization of local microcirculation is essential to preserve limbs and to obtain a good functional result. Microsurgical free tissue transfer is often necessary to achieve healing. An optimal therapeutic management with stable long-term clinical results can be achieved by the interaction of different surgical and medical disciplines.
ISSN:1433-0385
DOI:10.1007/s00104-013-2623-8