Antioxidant therapy with xymedon of patients with chronic osteomyelitis

An investigation of the antioxidant activity of blood plasma allowed a conclusion to be made of an alteration of the free radical processes in patients with chronic osteomyelitis. Experimental data on the influence of the antioxidants Xymedon and Methyluracil on the main free radicals, lipid peroxidation and chemiluminescence of peritoneal macrophages of rats allowed the substantiation of using the medicines in the complex treatment of patients in the pre- and postoperative periods. As a result, in 25 patients Xymedon improved the blood indices, increased antioxidant activity of plasma and reduced the amount of recurrences of the disease as compared with the patients taking Methyluracil.     

Psychosocial problems in patients with chronic osteomyelitis

52 patients suffering from a chronical bone infection were followed up with a special interest in psychosocial problems. In all cases psychosocial disturbances of different importance were evaluated. Possible causes have to be seen in long time of hospitalisation (average = 304 days), and apparent inadequate enlightenment of patients and in functionally and cosmetically insufficiencies. Conclusions are shown for the management in treatment of chronical bone infections.     

Complex treatment of patients with chronic osteomyelitis using osteoplasty

The work presents results of free bone autoplasty in 312 patients with chronic osteomyelitis of long bones. Complications were observed in 26.9% of the patients in the postoperative period. With regard for reoperations performed in patients with a complicated course of the disease, sanitation of pyonecrotic foci was achieved in 94.4% of the observations. Labour rehabilitation after operations of bone plasty was obtained in 65% of the patients.     

负压治疗技术在急、慢性骨感染中的应用

目的 探讨负压治疗技术在治疗急、慢性骨感染中的价值.方法 采用负压治疗技术.即在一段时间内将伤口置于密闭强力负压状态,治疗急、慢性骨感染患者30例(33个部位),辅助清创手术,应用敏感抗生素,应用植皮、肌皮瓣转移等方法闭合创面.结果 29个部位通过1次负压治疗就可达到创面闭合条件.所有患者均获随访,随访时间6～23个月,平均13.6个月,感染无复发.结论 负压治疗技术能有效控制急、慢性骨感染,缩短治疗时间,在骨感染治疗中有较好的应用前景.     

Main principles of etiotropic therapy in chronic osteomyelitis]

The results of prospective trial in 352 patients treated surgically for chronic osteomyelitis were presented: 151 patients with hematogenous and 201--with posttraumatic osteomyelitis. Various antibacterial treatment modalities were used for sanation of fistulas and purulent foci--chemical antiseptics, ultrasound, laser, flowing--lavage drainage, immobilized antibacterial drugs on various filling materials. Bacteriological examinations, including verification of pathogens and quantitative measurement of microbes in the tissues, has definitely proved effectiveness of such combined methods of treatment. The author suggests that sanation of the purulent focus should be applied in all stages of surgical treatment for such patients: during preparation for surgery, intraoperatively and in postoperative period.     

Long-term outcome of complex treatment of patients with chronic hematogenic osteomyelitis

The long-term outcomes of developed complex pathogenetic treatment of 318 patients with chronic hematogenous osteomyelitis were analyzed. This treatment is based on the monitoring of lipid peroxidation and natural antioxidants. The follow-up period was 7 years. The usage of this approach decreased the relapse rate to 11.7% in adults and to 5% in children.     

Antibacterial and immunocorrective therapy of diffuse purulent peritonitis]

The effectiveness of surgical treatment of 193 patients with generalized purulent peritonitis was analysed. The complex of bacteriologic and immunologic investigations contributed to optimization of antibacterial and immunocorrective therapy. Rational antibacterial therapy should be based on the principle of the use of broad and super-broad spectrum antibiotics with mandatory inclusion into the programme for treatment of metronidazole, administration of antibacterial agents before, at the time and after the operative intervention before identification of microflora and determination of its sensitivity to antibiotics. The therapeutic and tactical approach developed permitted to reduce lethality in generalized purulent peritonitis from 39.5 to 24.9%.     

Treatment of chronic osteomyelitis in children resistant to previous therapy

Patients admitted to the authors' institution with tibial osteomyelitis between 1978 and 1998 were reviewed. The purpose of this study was to determine the incidence, etiology, treatment, and outcome in chronic pediatric tibial osteomyelitis. The authors describe their treatment of chronic osteomyelitis in children resistant to previous therapeutic modalities. Thirty patients were identified with a mean age of 8.5 years at diagnosis. Mean age at admission was 9.6 years, indicating more than a 1-year duration of disease. Follow-up averaged 2.3 years. Patients underwent 97 procedures, averaging 3.2 procedures per patient. Hospital stay ranged from 2 weeks to 18 months, with an average stay of 4.7 months. Seventy-seven percent of patients were culture-positive, and 78% of positive cultures identified Staphylococcus aureus as the causative pathogen. Eighty percent of patients had a good outcome, 13% had a fair outcome, and there were no poor results. Patients with large tibial defects obtained good results with both tibiofibular synostosis and Ilizarov distraction osteogenesis. The authors describe the only reported group of pediatric patients successfully treated using Ilizarov bone transport for bony tibial defects due to osteomyelitis.     

Oral ciprofloxacin compared with standard parenteral antibiotic therapy for chronic osteomyelitis in adults

A group of fourteen patients who had chronic osteomyelitis and were treated with oral ciprofloxacin was compared with a group of twelve patients of similar age who had chronic osteomyelitis and received standard parenteral antibiotic therapy consisting of nafcillin, clindamycin, and gentamicin, singly or in combination. The osteomyelitis was arrested at the end of therapy and on follow-up examination of eleven patients in the first group and ten in the second group. The average duration of antibiotic therapy (thirty-eight days) and follow-up (approximately thirty months) were about the same for both groups. Oral administration of ciprofloxacin was as effective and safe as parenteral therapy for the treatment of osteomyelitis in these adults.