Newer perspectives in the treatment of chronic osteomyelitis: A preliminary outcome report.

The prevalence of chronic osteomyelitis due to trauma and surgical complications does not seem to be diminishing in our society. In many African Nations, with the urbanization and shift to the larger cities that has been occurring, Trauma has been classified as the number one disease problem plaguing such societies. This brings along with it the ensuing infections. With our better understanding of how microbes gain attachment to sites in our body and morph from a planktonic state to the slow growing sessile phase of growth, combined with their formation of a highly structured biofilm colony, we have come to realize that we must resort to other forms of treatment. This means changing our philosophical approach to treatment utilized over the past nearly 70 years involving complete reliance on chemotherapeutic agents with their resultant questionable efficacy in the treatment of chronic osteomyelitis. We report on preliminary early outcome results in the treatment of 127 patients with chronic osteomyelitis treated by a single surgeon in which all patients except those with underlying immunological impairment were treated with in-hospital intravenous antibiotics only. Only 5.5% of the patient population then received intravenous antibiotics following hospital discharge, and with this treatment approach there remained a 98.4% cure rate in the treatment of this chronic infection.