Delasotta Lawrence A, Hanflik Andrew, Bicking Griffin, Mannella William J
Kingsbrook Jewish Medical Center, Department of Orthopedic Surgery, Brooklyn, NY 11203, USA.
Open Orthop J. 2013 May 3;7:114-7. doi: 10.2174/1874325001307010114. Print 2013.
Post-traumatic osteomyelitis is a rare but debilitating complication of closed fractures. Most infections can be resolved with aggressive debridement, intravenous antibiotics, and hardware removal. However, the eradication of infection can be challenging in a patient with multiple comorbidities. Refractory infection may require suppressive therapy or amputation to control the disease. Improvements in care have led to improved survival for this population, posing new challenges in their post-traumatic care. We report on the successful use of hyperbaric oxygen therapy as an adjunct in a compromised host with recurrent post-traumatic osteomyelitis despite aggressive debridement, removal of instrumentation, and several courses of intravenous antibiotic therapy. Hyperbaric oxygen may be considered as an adjunct to standard treatment protocols for refractory osteomyelitis in compromised hosts.
创伤后骨髓炎是闭合性骨折一种罕见但使人衰弱的并发症。大多数感染通过积极清创、静脉使用抗生素及取出内固定物可以得到解决。然而,对于患有多种合并症的患者,根除感染可能具有挑战性。难治性感染可能需要抑制性治疗或截肢来控制病情。护理的改善使这一人群的生存率得到提高,在他们的创伤后护理中带来了新的挑战。我们报告了高压氧疗法成功作为辅助治疗用于一名尽管进行了积极清创、取出内固定器械及多疗程静脉抗生素治疗但仍反复发生创伤后骨髓炎的免疫功能低下宿主的情况。高压氧可被视为免疫功能低下宿主难治性骨髓炎标准治疗方案的辅助治疗手段。