Oral and maxillofacial surgery.
Acute and secondary chronic osteomyelitis.
Osteomyelitis therapy is composed of eradication (germ elimination) of the focus in combination with pathogen-specific antibiosis (antibiotic therapy). However, surgical bone removal is not yet recommended in the acute stage.
- Local foci remediation by ablation of infected and necrotic bone.
- Sequestrectomy – removal of necrotic (dead), rejected portions of bone.
- Freshening surrounding bone
- Decortication (surgical removal of the outer solid layer of bone) for better vascularization (vascularization of small vessels) of the medullary spaces.
- Storage antibiotic-loaded plastic chains.
- Decompression of intramedullary (“inside the medullary canal”) pressure.
- Explantation (“grafting“) of implants in the affected area.
- Extraction (tooth extraction) devitalized “dead”) teeth in the affected area.
- Soft tissue coverage
- Fracture stabilization (stabilization of a bone fracture).
- If necessary, partial jaw resection (surgical removal of part of the jaw bone) with subsequent defect reconstruction – e.g. autologous bone graft.
Primary chronic osteomyelitis
In early stages of the disease, decortication combined with removal of necrotic bone is usually successful. Nevertheless, the long-term prognosis is uncertain, resulting in wide therapeutic variability. Radical surgical measures should be refrained from. A combination of therapy with nonsteroidal or steroidal anti-inflammatory drugs and hyperbaric oxygen therapy (HBO) is known to be useful.
