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Bone infection
Osteomyelitis
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Osteomyelitis

Septic inflammatory bone disease - that can be due to direct trauma, surgery or hematogenous spread infection.
Bacterial infection promotes   ischemia and hypoxia to develop which interferes with local perfusion, function of white blood cell to kill bacteria, bone cells activity in removing dead infected bone and fibroblastic function of collagen synthesis.  Finally hypoxia limits antibiotics therapeutic function (inability to penetrate pus and inactivate microorganisms in condition of low oxygen tension).

Clinical symptoms:

local (wound infection with erythema, heat, swelling, tenderness, pain  and drainage)
systemic (septic fever , chills, dehydration, lethargy and some organ failure such as renal failure ).
Clinical application of HBO:

 


Symptoms / etiology 

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Rational for use of hyperbaric oxygen 

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Cost / benefits analysis

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References:

  1. Adams KR, Mader JT: Aminoglycoside potentiation with adjunctive hyperbaric oxygen    therapy in experimental Pseudomonas Aeruginosa osteomyelitis. Undersea Biomed Res; 14(suppl): 37, 1987
  2. Adams KR, Sutton TE,  Mader JT: In vitro potentiation of tobramycin under hyperoxic conditions. Undersea Biomed Res 14 (suppl): 37, 1987
  3. Aitasalo K, Niinikoski J, Grenman R, Virolainen E. A modified protocol for early treatment of osteomyelitis and Osteoradionecrosis of the mandible. Head Neck; 20(5): 411-7, Aug 1998
  4. Andel H, Felfernig M, Andel D, Blaicher W, Schramm W: Hyperbaric oxygen therapy in osteomyelitis. Anaesthesia; 53 Suppl 2:68-9, Review, May 1998
  5. Babior BM: Oxygen-dependent killing by phagocytes. New Eng J Med; 298:659-668, 1978
  6. Berg E, Barth E, Clarke D, Dooley L: The use of adjunctive hyperbaric oxygen in treatment of orthopedic infections and problem wounds: an overview and case reports. J Invest Surg; 2(4): 409-21, Review, 1989
  7. Calhoun JH, Cobos JA, Mader JT: Does hyperbaric oxygen have a place in the treatment of osteomyelitis. Orthopedic Clinics of North America; 22(3):467-471, 1991
  8. Chen CY, Lee SS, Chan YS, Yen CY, Chao EK, Ueng SW:  Chronic refractory tibia osteomyelitis treated with adjuvant hyperbaric oxygen: a preliminary report. Changgeng Yi Xue Za Zhi; 21(2): 165-71, Jun 1998
  9. Davis JC: Refractory osteomyelitis. Problem Wounds, The Role of Oxygen; Chpt. 4 Elsevier Science Publ Co; New York1988
  10. Davis JC, Heckman JD, Delee JC, Buckwold FJ:  Chronic non-hematogenous osteomyelitis treated with adjuvant hyperbaric oxygen. J Bone Joint Surg; 68: 1210-1217, 1986
  11. Eltorai I, Hart GB, Strauss MB: Osteomyelitis in the spinal cord injured: a review and a preliminary report on the use of hyperbaric oxygen therapy. Paraplegia; 22(1):17-24 Feb 1984
  12. Esterhai JL, Pisarello J, Brighton CT, Heppenstall RB, Gellman H, Goldstein G: Adjunctive hyperbaric oxygen therapy in the treatment of chronic refractory osteomyelitis. J Trauma; 27(7): 763-8, Jul 1987
  13. Evans BE, Jacobson JH, Peirce EC, Friedman EW, Schwartz AE:  Chronic osteomyelitis of mandible. NY State J Med; 76(6): 966-967, 1976
  14. Hunt KT, Linsey M, Grislis G, Sonne M, Jawetz E: the effect of differing ambient oxygen tension on wound infection. Annals of surgery; 181 (1):35-39, Jan 1975
  15. Jamil MU, Eckardt A, Franko W: Hyperbaric oxygen therapy. Clinical use in treatment of  osteomyelitis, osteoradionecrosis and reconstructive surgery of the irradiated mandible. Mund KieferGesichtschir; 4(5): 320-3, Sep. 2000
  16. Jain KK: Hyperbaric Oxygen Therapy in Infection. Hyperbaric Medicine; 13:189–211, 1999
  17. Jones HP: The role of oxygen and its derivatives in bacterial killing and inflammation. In Gottlieb SF, Longmuir IS., and Totter JR. (eds): Oxygen: An In-Depth Study of its Pathophysiology. Bethesda, Maryland: Undersea Medical Society; pp. 493-516, 1984
  18. Keck PE, Gottlieb SF, Conley J: Interaction of increased pressures of oxygen and sulfonamides on the in vitro and in vivo growth of pathogenic bacteria. Undersea Biomed Res 7:95-106, 1980
  19. Kindwall EP: The use of Hyperbaric Oxygen in Treatment of Osteomyelitis  Hyperbaric Medical Practice; 23:604 –613, 1999
  20. Knighton DR, Halliday B, Hunt TK: Oxygen a an  antibiotics: The effect of inspired Oxygen on infection. Arch Surg; 119; 199-204, Feb 1984
  21. Leonov VM: The necessity and principles of oxygen therapy in human infection Terapevticheskii Arkhiv; 34 (2): 101, 1962
  22. Mader JT, Adams KR, Wallace WR, Calhoun JH: Hyperbaric oxygen as adjunctive therapy for osteomyelitis. Infect Dis Clin North Am; 4(3): 433-40, Review, Sep 1990
  23. Mainous EG, Boyne PJ, Hart GB: Hyperbaric oxygen treatment of mandibular osteomyelitis: Report of three cases. J Am Dent Assoc; 87: 1426-1430, 1973
  24. Maynor ML, Moon RE, Camporesi EM, Fawcett TA, Fracica PJ, Norvell HC, Levin LS: Chronic osteomyelitis of the tibia: treatment with hyperbaric oxygen and autogenous microsurgical muscle transplantation. J South Orthop Assoc; 7(1): 43-57, 1998
  25. Morrey BF, Dunn JM, Heimbach RD, Davis J: Hyperbaric oxygen and chronic osteomyelitis. Clin  Orthop; 144:121-127, 1979
  26. Norden CW, Kleti E: Experimental osteomyelitis caused by Pseudomonas aeruginosa. J Infect Dis; 141:71-75, 1980
  27. Waisman D, Shupak A, Weisz G, Melamed Y: Hyperbaric oxygen therapy in the pediatric patient: the experience of the Israel Naval Medical Institute. Pediatrics; 102(5): E53, Nov 1998
  28. Schweitzer VG: Hyperbaric oxygen management of chronic staphylococcal osteomyelitis of the temporal bone. Am J Otol; 11(5): 347-53, Sep 1990