Current opinions on the mechanism, classification, imaging diagnosis and treatment of post-traumatic osteomyelitis

Yang, Jian; Yao, Jiangling; Wu, Ziquan; Zeng, De-Lu; Zheng, Lin-Yang; Chen, Dong; Guo, Zhiliang; Peng, Lei

doi:10.1016/j.cjtee.2021.07.006

Cited by 17 publications

(20 citation statements)

References 89 publications

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“…[ 3 ] Patients with infection generally present with advanced age, hypertension, anemia, low protein, and hyperglycemia, and this result indicates a correlation between the occurrence of infection and the patient’s health. [ 4 ] At the same time, we found that the prehospital visit time of infected patients is long, far exceeding the optimal treatment time, which may be an important factor leading to infection, and the long prehospital visit time can also lead to a large amount of blood loss. These are an important reason for the high white blood cell count and low red blood cell count in infected patients.…”

Section: Discussionmentioning

confidence: 99%

Analysis of clinical characteristics, pathogen infection, and drug sensitivity of Marine injury patients: A cross-sectional study

et al. 2022

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The infection rate is high in patients injured at sea, and because of the unique distribution of marine microorganisms, the infection is often not easily controlled effectively with the empirical application of antibiotics. This study aims to consider the clinical characteristics and pathogen infection and drug susceptibility of patients injured at sea. From 2019 to 2021, there were 635 patients injured at sea in Rizhao People's Hospital. We assess the patient's basic condition, while performing bacterial culture and drug susceptibility testing on wound exudate or pus from infected patients. Among the 635 patients injured at sea, 195 people were infected, and the infection rate was 30.71%. Infected patients are usually older, have longer prehospital visits, and have lower normal levels of red blood cells, hemoglobin, total protein, and albumin. The causes of injury in infected patients were mainly avulsion and puncture injuries, and the types of injuries were mainly bone fracture, vascular injury, and nerve injury. A total of 305 strains of pathogenic bacteria were cultured in 195 patients. Gram-negative bacteria accounted for 77.05% (235 strains), of which Proteus was the most. Gram-positive bacteria accounted for 22.95% (70 strains), of which Staphylococcus aureus was the most. Gram-negative bacilli were sensitive to aminoglycosides, lactam antibiotics, carbapenems antibiotics, sulfonamides, quinolones, fourth-generation cephalosporins, and antibacterial drugs containing enzyme inhibitors, while most of the bacteria were resistant to penicillins, first-generation cephalosporins, and second-generation cephalosporins. Gram-positive bacteria were sensitive to quinuptin/dafoptin, rifampicin, linezolid, gentamicin, tigacycline, and vancomycin but resistant to penicillin antibiotics. Due to the particularity of marine injuries, patients are prone to infection. Pathogen culture and drug sensitivity analysis play an important role in guiding antiinfective treatment for marine injured patients.Abbreviations: ALB = Albumin, GLU = glucose, GSP = glycosylated serum protein, HGB = hemoglobin, PLT = platelet, RBC = red blood cell, TP = total protein, WBC = white blood cell.

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Section: Discussionmentioning

confidence: 99%

Analysis of clinical characteristics, pathogen infection, and drug sensitivity of Marine injury patients: A cross-sectional study

et al. 2022

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“…In acute post-traumatic as well as in chronic osteomyelitis, surgery with debridement and antimicrobial/antibiotic therapy are recommended. Drainage and wound closure are further important steps of infection control [59,60]. The use of external fixators, sometimes in combination of negative pressure closed drainage is another example of the condition's clinical management [60].…”

Section: Osteomyelitismentioning

confidence: 99%

“…Drainage and wound closure are further important steps of infection control [59,60]. The use of external fixators, sometimes in combination of negative pressure closed drainage is another example of the condition's clinical management [60]. Given the nature of the disease and its treatment, experts' evaluation of osteomyelitis as a contraindication of foam rolling presents as apparent and logical.…”

Section: Osteomyelitismentioning

confidence: 99%

Expert Consensus on the Contraindications and Cautions of Foam Rolling—An International Delphi Study

Bartsch

Baumgart

Freiwald

et al. 2021

JCM

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Background: Foam rolling is a type of self-massage using tools such as foam or roller sticks. However, to date, there is no consensus on contraindications and cautions of foam rolling. A methodological approach to narrow that research gap is to obtain reliable opinions of expert groups. The aim of the study was to develop experts’ consensus on contraindications and cautions of foam rolling by means of a Delphi process. Methods: An international three-round Delphi study was conducted. Academic experts, defined as having (co-) authored at least one PubMed-listed paper on foam rolling, were invited to participate. Rounds 1 and 2 involved generation and rating of a list of possible contraindications and cautions of foam rolling. In round 3, participants indicated their agreement on contraindications and cautions for a final set of conditions. Consensus was evaluated using a priori defined criteria. Consensus on contraindications and cautions was considered as reached if more than 70% of participating experts labeled the respective item as contraindication and contraindication or caution, respectively, in round 3. Results: In the final Delphi process round, responses were received from 37 participants. Panel participants were predominantly sports scientists (n = 21), physiotherapists (n = 6), and medical professionals (n = 5). Consensus on contraindications was reached for open wounds (73% agreement) and bone fractures (84%). Consensus on cautions was achieved for local tissue inflammation (97%), deep vein thrombosis (97%), osteomyelitis (94%), and myositis ossificans (92%). The highest impact/severity of an adverse event caused by contraindication/cautions was estimated for bone fractures, deep vein thrombosis, and osteomyelitis. Discussion: The mechanical forces applied through foam rolling can be considered as potential threats leading to adverse events in the context of the identified contraindications and cautions. Further evaluations by medical professionals as well as the collection of clinical data are needed to assess the risks of foam rolling and to generate guidance for different applications and professional backgrounds.

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“…It is also the primary symptom of the postoperative infection of open fractures. Osteomyelitis is easily caused by bacteria that enter the bone tissue after damage and multiply quickly in huge numbers [2]. With an incidence of 21.8 per 100,000 people/year in the United States, osteomyelitis is one of the most difficult conditions for both doctors and patients [3].…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and Treatment Modalities for Osteomyelitis

Jha¹,

Chaudhary²

2022

Cureus

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Osteomyelitis is an infection-related inflammatory disease of the bones. Imaging and laboratory results are typically used to support a clinical diagnosis of osteomyelitis. Microbial cultures and bone biopsies provide conclusive diagnoses. The first imaging procedure that needs to be done is radiography, but its sensitivity is low in the early stages of the disease. The sensitivity of magnetic resonance imaging, both with and without contrast material, is higher for detecting areas of bone necrosis in advanced stages. Patients can be categorised for surgical treatment using a staging system based on major and minor risk factors. The main course of treatment should be antibiotics, which should be chosen depending on the findings of the culture and the characteristics of each patient. Bony debridement surgery is frequently required, and in high-risk patients or those with severe illness, additional surgical intervention can be necessary. Better outcomes are being attained in the treatment of this illness thanks to advancements in surgical treatment, antibiotic therapy, and the current resources for precise diagnosis and tailored responses to each kind of osteomyelitis.The classification systems that are most frequently employed, as well as the general epidemiological ideas, are presented together with the discussion of acute and chronic osteomyelitis. The key recommendations for diagnosing infections clinically, in the laboratory, and through imaging are covered, along with the recommendations for surgical and antibiotic procedures, and the function of hyperbaric oxygen as adjuvant therapy. We evaluate the osteomyelitis-related articles, summarise the most recent developments in diagnostic procedures and therapeutic regimens, evaluate the benefits and drawbacks of various diagnostic modalities and therapeutic approaches, and suggest areas of focus to help current diagnostic and therapeutic approaches.

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Current opinions on the mechanism, classification, imaging diagnosis and treatment of post-traumatic osteomyelitis

Cited by 17 publications

References 89 publications

Analysis of clinical characteristics, pathogen infection, and drug sensitivity of Marine injury patients: A cross-sectional study

Analysis of clinical characteristics, pathogen infection, and drug sensitivity of Marine injury patients: A cross-sectional study

Expert Consensus on the Contraindications and Cautions of Foam Rolling—An International Delphi Study

Diagnosis and Treatment Modalities for Osteomyelitis

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