دورية أكاديمية
Surgical debridement in long bone chronic osteomyelitis: is wide tumour-like resection necessary?
| العنوان: | Surgical debridement in long bone chronic osteomyelitis: is wide tumour-like resection necessary? |
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| المؤلفون: | Langit MB; Department of Orthopaedics, Hull University Teaching Hospitals NHS Trust, Hull, UK.; Department of Orthopedics, Philippine Orthopedic Center, Quezon City, Philippines., Tay KS; Department of Orthopaedics, Hull University Teaching Hospitals NHS Trust, Hull, UK., Al-Omar HK; Department of Orthopaedics, Hull University Teaching Hospitals NHS Trust, Hull, UK., Barlow G; Department of Infectious Diseases, Hull University Teaching Hospitals NHS Trust, Hull, UK., Bates J; Department of Radiology, Hull University Teaching Hospitals NHS Trust, Hull, UK., Chuo CB; Department of Plastic and Reconstructive Surgery, Hull University Teaching Hospitals NHS Trust, Hull, UK., Muir R; Department of Orthopaedics, Hull University Teaching Hospitals NHS Trust, Hull, UK., Sharma H; Department of Orthopaedics, Hull University Teaching Hospitals NHS Trust, Hull, UK. |
| المصدر: | Bone & joint open [Bone Jt Open] 2023 Aug 24; Vol. 4 (8), pp. 643-651. Date of Electronic Publication: 2023 Aug 24. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: The British Editorial Society of Bone & Joint Surgery Country of Publication: England NLM ID: 101770336 Publication Model: Electronic Cited Medium: Internet ISSN: 2633-1462 (Electronic) Linking ISSN: 26331462 NLM ISO Abbreviation: Bone Jt Open Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: London : The British Editorial Society of Bone & Joint Surgery, [2020]- |
| مستخلص: | Aims: The standard of wide tumour-like resection for chronic osteomyelitis (COM) has been challenged recently by adequate debridement. This paper reviews the evolution of surgical debridement for long bone COM, and presents the outcome of adequate debridement in a tertiary bone infection unit. Methods: We analyzed the retrospective record review from 2014 to 2020 of patients with long bone COM. All were managed by multidisciplinary infection team (MDT) protocol. Adequate debridement was employed for all cases, and no case of wide resection was included. Results: A total of 53 patients (54 bones) with median age of 45.5 years (interquartile range 31 to 55) and mean follow-up of 29 months (12 to 59) were included. In all, ten bones were Cierny-Mader type I, 39 were type III, and five were type IV. All patients were treated with single-staged management, except for one (planned two-stage stabilization). Positive microbial cultures grew in 75%. Overall, 46 cases (85%) had resolution of COM after index procedure, and 49 (90.7%) had resolution on last follow-up. Four patients (7%) underwent second surgical procedure and six patients (11%) had complications. Conclusion: We challenge the need for wide tumour-like resection in all cases of COM. Through detailed preoperative evaluation and planning with MDT approach, adequate debridement and local delivery of high concentration of antibiotic appears to provide comparable outcomes versus radical debridement. Competing Interests: G. Barlow reports participation on a data safety monitoring Board or advisory board for BioMerieux, which is unrelated to this work. Cher B. Chuo declares registration sponsorship for faculty presentations at the 42nd Société Internationale de Chirurgie Orthopédique et de Traumatologie (Orthopaedic World Congress), which is unrelated. H. Sharma discloses payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events for Biocomposites; and being in a leadership or fiduciary role in other board, society, committee or advocacy group for the British Limb Reconstruction Society, SICOT, the Journal of Limb Lengthening and Reconstruction, and the Journal of Orthopaedics. (© 2023 Author(s) et al.) |
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| تواريخ الأحداث: | Date Created: 20230823 Latest Revision: 20230826 |
| رمز التحديث: | 20230826 |
| مُعرف محوري في PubMed: | PMC10446974 |
| DOI: | 10.1302/2633-1462.48.BJO-2023-0017.R1 |
| PMID: | 37611921 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2633-1462 |
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| DOI: | 10.1302/2633-1462.48.BJO-2023-0017.R1 |