Chronic osteomyelitis: what the surgeon needs to know.
Chronic osteomyelitis: what the surgeon needs to know.
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DOI：
10.1302/2058-5241.1.000017
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发表时间：
2016-05
影响因子：
3.4
通讯作者：
Giannoudis PV
中科院分区：
文献类型：
--
作者：
Panteli M;Giannoudis PV
慢性骨髓炎是由病原体引起的一种渐进性炎症过程，导致骨质破坏和死骨形成。
它可能会出现时长不一的静止期，而其发生、类型、严重程度和预后是多因素的。
慢性骨髓炎诊断的“金标准”是骨培养阳性以及骨的组织病理学检查。
对于治疗医生来说，其治疗仍然具有挑战性，需要多学科协作，包括放射科医生、擅长传染病的微生物学家、骨科医生和整形外科医生。
治疗应根据每个患者症状的严重程度和持续时间，以及对治疗的临床和影像学反应进行调整。
在所有病例中都应考虑抗菌治疗和手术治疗相结合，包括适当的死腔处理和后续重建。即使在看似治疗成功之后，也可能复发，这对患者的生活质量有重大影响，并且对任何医疗保健系统来说都是沉重的经济负担。
引用本文：EFORT Open Rev 2016;1:128–135. DOI: 10.1302/2058 - 5241.1.000017
Chronic osteomyelitis represents a progressive inflammatory process caused by pathogens, resulting in bone destruction and sequestrum formation. It may present with periods of quiescence of variable duration, whereas its occurrence, type, severity and prognosis is multifactorial. The ‘gold standard’ for the diagnosis of chronic osteomyelitis is the presence of positive bone cultures and histopathologic examination of the bone. Its management remains challenging to the treating physician, with a multidisciplinary approach involving radiologists, microbiologists with expertise in infectious diseases, orthopaedic surgeons and plastic surgeons. Treatment should be tailored to each patient according the severity and duration of symptoms, as well as to the clinical and radiological response to treatment. A combined antimicrobial and surgical treatment should be considered in all cases, including appropriate dead space management and subsequent reconstruction. Relapse can occur, even following an apparently successful treatment, which has a major impact on the quality of life of patients and is a substantial financial burden to any healthcare system. Cite this article EFORT Open Rev 2016;1:128–135. DOI: 10.1302/2058-5241.1.000017.