Abstract

GEURTS, J et al. Contemporary treatment of chronic osteomyelitis: implementation in low- and middle-income countries. SA orthop. j. [online]. 2018, vol.17, n.2, pp.40-43. ISSN 2309-8309.  https://doi.org/10.17159/2309-8309/2018/v17n2a7.

AIM: Chronic osteomyelitis is still a difficult problem to treat in the developed world, but even more so in low- and middle-income countries. Contemporary treatment options result in satisfying outcomes in a setting with abundant resources, but the question is whether these treatment options can be translated to other, less supported health care systems and if they obtain the same results. METHODS: Eighteen patients with established chronic osteomyelitis (eight type III, ten type IV) were prospectively enrolled and treated in a one-stage procedure with radical debridement and dead space management using bioactive glass S53P4 granules, together with adjuvant antibiotic therapy. RESULTS: Thirteen patients were assessed at 24 months. Infection control was achieved in Ave patients (38%). Eight patients (61.5%) had persistence or recurrence of infection. Loss to follow-up was substantial (Ave patients, 28%). CONCLUSION: Due to specific challenges treating chronic osteomyelitis in low- and middle-income countries, contemporary treatment options cannot be 'copy-pasted' with the same results in these settings. LEVEL OF EVIDENCE: Level 4.

Keywords : osteomyelitis; bio-active glass; biomaterial; low and middle-income countries.

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