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Bioactive glass as dead space management following debridement of type 3 chronic osteomyelitis

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Abstract

Background

Chronic osteomyelitis is a challenging condition to treat and although no exact treatment guidelines exist, the surgical management strategy includes wide resection of necrotic and infected bone followed by dead space management. This study evaluates the use of bioactive glass as a single-stage procedure for dead space management following surgical debridement.

Methods

A consecutive series of 24 patients with Cierny-Mader type 3 osteomyelitis, treated between March 2016 and June 2018, were identified and evaluated retrospectively. Patients were managed with bioactive glass as dead space management following surgical debridement.

Results

Of the patients who completed more than 12 months follow-up, all fourteen (100%) showed complete resolution of symptoms. Of the remaining ten patients with less than 12 months follow-up, eight had complete resolution of symptoms. Therefore, a preliminary result of 22 out of 24 patients (91.65%) had resolution of symptoms following debridement and dead space management with bioactive glass. One patient experienced a complication related to the use of bioactive glass. This manifested as prolonged serous wound drainage that resolved with local wound care.

Conclusion

The use of bioactive glass appears to be effective for dead space management following debridement of anatomical type 3 chronic osteomyelitis of the appendicular skeleton.

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Authors and Affiliations

  1. Division of Orthopaedics, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Tygerberg Hospital, Stellenbosch University, Cape Town, 7505, South Africa

    Willem Oosthuysen, Rudolph Venter, Yashwant Tanwar & Nando Ferreira

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  1. Willem Oosthuysen
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  2. Rudolph Venter
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  4. Nando Ferreira
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Correspondence to Nando Ferreira.

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Oosthuysen, W., Venter, R., Tanwar, Y. et al. Bioactive glass as dead space management following debridement of type 3 chronic osteomyelitis. International Orthopaedics (SICOT) 44, 421–428 (2020). https://doi.org/10.1007/s00264-019-04442-7

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