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Year : 1981  |  Volume : 15  |  Issue : 2  |  Page : 211-216

Treatment Of Chronic Osteomyelitis With Continuous Irrigation Suction Technique



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A. S Bajaj


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No other common process in orthopaedics has been so refractory to treatment as is chronic osteomyelitis. Its treatment has varied from the use of boiling water to various reconstructive operations of today. Recurrences occur in patients of chronic osteomyelitis after treatment because of the fact that bacteria are widespread in the necrotic tissue, haversian canals, or within the medullary cavity. Subperiosteal vessels and often the main nutrient artery are thrombosed and consequently the antibiotics fail to reach the organisms. Even after surgical removal of dead tissue, sequestra, excision of sinuses and saucerisation, the dead space left is filled up by a haematoma which is a potential site of infection. So a technique had to be thought of in which dead bone and scar tissue were excised, dead space eliminated and perfused with antibiotic solution locally. Wound irrigation in treatment of chronic osteomyelitis dates back to at least 1917 by Duman and Carrel. Closed continuous circulation of a solution containing antibiotic was first used by Goldmann et al. (1960). Mc Elvenny (1961) developed the detailes of the technique. This technique has subsequently been used by several other workers (Dombrowski and Dunn 1965, Kelly et al. 1970, Taylor et al. 1970, Michelinakis 1972, Clawson et al. 1973, Letts and Wong 1975, Kawashima 1975, Rao and Sahu 1978), however extensive clinical trials have not taken place. We report herewith results of the treatment of chronic osteomyelitis with the continuous irrigation technique in 30 cases.


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