• 1

    Kowalski TJ, Matsuda M, Sorenson MD, et al.: The effect of residual osteomyelitis at the resection margin in patients with surgically treated diabetic foot infection. J Foot Ankle Surg 50: 171, 2011.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2

    Atway S, Nerone VS, Springer KD, et al.: Rate of residual osteomyelitis after partial foot amputation in diabetic patients: a standardized method for evaluating bone margins with intraoperative culture. J Foot Ankle Surg 51: 749, 2012.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3

    Jenny G: Local antibiotic therapy using gentamicin-PMMA chains in post-traumatic bone infections: short and long-term results. Reconstr Surg Traumatol 20: 36, 1988.

    • Search Google Scholar
    • Export Citation
  • 4

    Jogia RM, Modha DE, Nisal K, et al.: Use of highly purified synthetic calcium sulfate impregnated with antibiotics for the management of diabetic foot ulcers complicated by osteomyelitis. Diabetes Care 38: e79, 2015.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5

    Barshes NR, Mindru C, Ashong C, et al.: Treatment failure and leg amputation among patients with foot osteomyelitis. Int J Low Extrem Wounds 15: 303, 2016.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6

    Lee S, Harkless LB: Risk of reamputation in diabetic patients stratified by limb and level of amputation: a 10-year observation. Diabetes Care 29: 566, 2006.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7

    Izumi Y, Satterfield K, Lee S, et al.: Risk of reamputation in diabetic patients stratified by limb and level of amputation: a 10-year observation. Diabetes Care 29: 566, 2006.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8

    Cierny G III. Surgical treatment of osteomyelitis. Plast Reconstr Surg 127: 190S, 2011.

  • 9

    Lin BR, Caldwell C, Bhaduri S, et al.: Optimizing vancomycin release from calcium phosphate-based cement by carboxymethyl cellulose for prevention of osteomyelitis. Surg Infect 18: 221, 2017.

    • Crossref
    • Search Google Scholar
    • Export Citation

Decreasing Osteomyelitis Occurrence in Remaining Bone After Partially Resected Infected Bone

Jeffrey C. KarrThe Osteomyelitis Center of Central Florida, 5421 S Florida Ave, Lakeland, FL 33813

Search for other papers by Jeffrey C. Karr in
Current site
Google Scholar
PubMed
Close
 DPM
Restricted access

Background: After partial bone resection for osteomyelitis there is a high rate of osteomyelitis occurrence in the remaining bone due to adherent bacterial biofilm, dysvascular infected spongiosum bone, and absence of a surgical technique that can prevent osteomyelitis developing in the remaining bone.

Methods: Presented is a surgical procedure using a dicalcium phosphate bone void filler putty with antibiotics placed into the remaining bone to prevent the development of osteomyelitis, therefore preventing amputation.

Results: This procedure has an osteomyelitis eradication rate of 94.8% and also decreases the rate of lower-extremity amputations.

Conclusions: This procedure provides a single stage surgical technique for infected open bone defects decreasing the previously reported high osteomyelitis reoccurrence rate of 57.1% to 5.2%.