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Osteomyelitis of the Jaws pp 191–204Cite as

Osteomyelitis Therapy – Hyperbaric Oxygen as an Adjunct in Treatment of Osteomyelitis of the Jaws

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Abstract

In craniofacial and head/neck infections, with or without bone involvement, surgery is the mainstay of treatment. Antibiotics are always used as adjuncts, although there are few studies documenting evidence of their efficacy in this setting. There is a large body of in-vitro and in-vivo experimental evidence which shows that hyperbaric oxygen (HBO) is able to counteract the deleterious effects of local hypoxia on infection and wound healing. Experimental data show that HBO has a direct antibacterial effect equivalent to antibiotics for strictly anaerobic bacteria. Other experimental data show an improvement of neutrophils mediated bacterial killing for P. aeruginosa, S. aureus, and B. melaninogenicus. In experimental animal osteomyelitis, HBO compares favorably with the antibacterial effect of cephalosporins, gentamicin, amikacin, and tobramycin, showing even an additive effect. Clinical results confirm the experimental data, although controlled studies are still lacking. Hyperbaric oxygen seems to be associated with better survival in severe cervical necrotizing soft tissue infections. Hyperbaric oxygen allows a better infection demarcation in chronic osteomyelitis of the jaw. As a consequence, less major surgery seems to be required for infection control. Adjunctive HBO improves outcomes and reduces the need for surgical reintervention, and furthermore in some instances allows infection control without mandatory removal of foreign material. Hyperbaric oxygen, associated with standard care, has further been associated with improved survival as well as better infection control in zygomycosis (mucormycosis) of the older diabetic patient.

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  1. Center for Hyperbaric Oxygen, Kleinhüningerstrasse 177, 4057, Basel, Switzerland

    Jörg Schmutz

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  1. Jörg Schmutz
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  1. Center for Jaw Surgery and Facial Plastic Surgery, Zürcherstrasse 7, 8400, Winterthur, Switzerland

    Marc M. Baltensperger

  2. Maxillofacial, Facial Plastic, Head and Neck Surgery, Oberdorfstrasse 41, 8853, Lachen, Switzerland

    Gerold K. H. Eyrich

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Schmutz, J. (2009). Osteomyelitis Therapy – Hyperbaric Oxygen as an Adjunct in Treatment of Osteomyelitis of the Jaws. In: Baltensperger, M., Eyrich, G. (eds) Osteomyelitis of the Jaws. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-28766-7_10

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