HYPERBARIC TREATMENT OF CHRONIC REFRACTORY OSTEOMYELITIS

Course overview

OSTEOMYELITIS IS INFECTION OF THE BONE OR MARROW CAUSED BY BACTERIA OR MYCOBACTERIA. IT IS DIFFICULT TO TREAT DUE TO THE RELATIVE PAUCITY OF BLOOD VESSELS IN BONE AND THE FACT THAT MANY ANTIMICROBIALS DO NOT PENETRATE BONE WELL. REFRACTORY OSTEOMYELITIS IS A CHRONIC OSTEOMYELITIS THAT DOES NOT RESPOND OR THAT RETURNS AFTER APPROPRIATE TREATMENT. PATIENTS PRESENTING WITH OSTEOMYELITIS TO THE SPINE, SKULL, OR STERNUM HAVE A HIGH RISK FOR MORBIDITY AND MORTALITY FROM THIS INFECTION. THE STANDARD TREATMENT FOR CHRONIC AND REFRACTORY OSTEOMYELITIS INCLUDE SURGICAL DEBRIDEMENT AND CULTURE DIRECTED ANTIBIOTICS. HYPERBARIC OXYGEN TREATMENTS CAN BE CONSIDERED AN AMERICAN HEART ASSOCIATION (AHA) CLASS II RECOMMENDATION FOR THE TREATMENT OF CHRONIC, REFRACTORY OSTEOMYELITIS. THIS ACTIVITY DESCRIBES THE PATHOPHYSIOLOGY OF OSTEOMYELITIS AND HIGHLIGHTS THE ROLE OF THE INTERPROFESSIONAL TEAM IN THE MANAGEMENT OF THESE PATIENTS.