What are the treatments for chronic osteomyelitis

  Regardless of the cause of chronic osteomyelitis, the treatment is very tricky, because the bones and soft tissue skin and other different, bacterial infection into the bones, it is difficult to penetrate the drug inside, through mechanical methods such as squeezing pus drainage and other methods do not work, the bone is too hard, unlike soft tissue, a squeeze pus out. So, once you get osteomyelitis, it’s really very, very annoying. It is important to discuss the treatment methods that may be helpful to the patients.  The first, is the very traditional clearing and then changing the medication, opening the bone cortex and filling it with oil, the effect is not sure, the treatment period is long, called Orr surgery, and changing the medication is known to be very smelly and unpleasant.  The second, after debridement, two tubes are placed in the wound, one dripping medicine into, and one dripping water out, which is called drip drainage method, need to drip for a long time, the tube is very bad to deal with, easy to block or detach the tube, the effect is also not sure.  The third, after clearing the wound, with local muscle filling method, mainly for the treatment of heel bone osteomyelitis, the effect is good, the reason is to use the muscle blood supply is rich, contains more oxygen, and can not leave dead cavity, so can be cured. However, this method, like the first two, cannot solve the problem of bone defects caused by debridement, so doing so in the long bone stem can easily cause fractures.  In the fourth type, after debridement, the cavity is filled with artificial bone containing antibiotics or artificial bone containing antibiotics and BMP, with the purpose that one is the slow release of antibiotics to kill the bacteria and heal the inflammation, and the other is that the artificial bone can fill the cavity by osteogenesis. There is a possibility of success, however, because it contains antibiotics and BMP (bone morphogenetic protein), so the rejection is very strong, and the wound always oozes out, and it is not clear whether it is osteomyelitis oozing or rejection oozing, which makes doctors play a small drum psychologically.  The fifth is the Papineau method, invented in 1960 by Canadian orthopedic surgeons, L, J, papineau, and improved in 1968 by R, Roy-Camille’s, with good results, this method includes: (1) thorough lesion removal. (2) Open cancellous bone grafting with bone grafting while draining. (3) Continuous repeated irrigation.  The sixth type, that is, complete removal of the inflamed segment as a whole and then repair of the bone defect by bone lengthening or microscopic fibula grafting to the method, can be completely cured. This method is adapted to people with traumatic bone discontinuity, and it is a little difficult to deal with the infection of the epiphysis, sometimes it needs to sacrifice the joint, and it is more traumatic, however, among all the above methods, this is the one with the best results.