Treatment of acute osteomyelitis in children by closed-tube irrigation: a reassessment.

The addition of closed-tube irrigation to incision and drainage in the treatment of children with acute osteomyelitis has been found to be associated with: (a) a rate of technical complications of 60%, the most common complications being leaking and plugging of the tube; (b) a 30% rate of superinfection at the site of the wound, the most common organism being Pseudomonas; and (c) an average postoperative hospital stay of 30 days compared with only 16 days for the patients treated by incision and drainage alone. Suction-irrigation in the treatment of acute osteomyelitis in children does not appear to be essential for successful management, and introduces added risks of superinfection and technical complications.