DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20163295

Debridement with high speed burr reduce more colonies of Staphylococcus aureus in chronic osteomyelitis of rabbit’s tibia compare to debridement with curettage

Su Djie To Rante, Henry Ricardo Handoyo

Abstract


Background: Chronic osteomyelitis has been a difficult problem for the patient and for the treating physician. Chronic osteomyelitis is defined by most authors as osteomyelitis with symptoms that have been present for more than 1 month. Chronic osteomyelitis also defined by an infected dead bone within compromise soft tissue. An aggressive debridement and specific antibiotic treatment is first choice for chronic osteomyelitis. The purpose of this study was to assess the reduction in the number of colonies of Staphylococcus aureus after debridement with a high speed burr compared to debridement with curettage.

Methods: This study is an experimental study was designed using a randomized post-test only group design. A total of 42 rabbits inoculated his right tibia with 0.1 ml Staphylococcus aureus 107 CFU / ml, and then inserted with K-wire intramedullary. Two weeks after inoculation, chronic osteomyelitis occurs, grade 3 and 4 radiologically. Then 10 rabbits were sacrificed without debridement, colonies of germs counted as control, 16 rabbits was performed debridement with curettage and 16 rabbits was performed debridement with high speed burr. Three weeks after debridement, 32 rabbits was sacrificed and counted for final germs colonies.

Results: The results obtained from debridement with high speed burr and debridement with curettage, number of colonies of Staphylococcus aureus is less than the number of control’s colonies, with a value of p = 0.006 (p <0.05), debridement with a high speed burr also decrease the number of colonies of Staphylococcus aureus compared to debridement with curettage, with p = 0.023 (p<0.05), odds ratio of 9.000 (CI=95%). This is shows that this difference is statistically significant.

Conclusions: The data showed that debridement with a high speed burr more likely to decrease the number of colonies of germs that can be recommended as a method of debridement for chronic osteomyelitis.


Keywords


Debridement, High speed burr, Curettage, Chronic osteomyelitis

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References


Patzakis MJ, Zalavras CG. Chronic posttraumatic osteomyelitis and infected non-union of the tibia: current management concepts. Journal of the American Academy of Orthopaedic. 2005;13(6):417-27.

Dormans JP, Drummond DS. Pediatric Hematogenous Osteomyelitis: New Trends in Presentation, Diagnosis, and Treatment. J Am Academy of Orthopaedic Surgeons. 1994;2:333-41.

Cierny G, Mader JT, Penninck JJ. A Clinical staging sistem for adult osteomyelitis. Clinical Orthopaedics and Related Research. 2003;414:7-24.

Wirganowicz PZ. Aggressive Surgical Management of Chronic Osteomyelitis. The University of Pennsylvania Orthopaedic Journal. 1999;12:7-12.

Lazzarini L, Mader JT, Calhoun JH. Current Concepts Review : Osteomyelitis in Long Bones. Journal Bone Joint Surgery. 2004;86;10.

Spiegel DA, Penny JN. Chronic Osteomyelitis in Children. Techniques in Orthopaedics. 2004;20(2):142-52.

Patrick PL, Spencer JF. Intralesional Treatment of Bone Tumors in: Operative Technique in Orthopaedics. 2005;14:251-8.

Augustin G, Zigman T, Davila S, Udilljak T, Staroveski T, Brezak D, et al. Cortical bone drilling and thermal osteonecrosis. Clinical Biomechanics. 2012;27:313-25.

Song KM, Sloboda JF. Acute Hematogenous Osteomyelitis in Children. J Am Academy of Orthopaedic Surgeons. 2001;9(3):166-75.

Simpson AHRW, Deakin M, Latham JM. Chronic osteomyelitis. The effect of the extent of surgical resection on infection-free survival. J Bone Joint Surg [Br]. 2001;83:403-7.

Lazzarini L, Mader JT, Calhoun JH. Current Concepts Review: Osteomyelitis in Long Bones. Journal Bone Joint Surgery. 2004;86;10.

Shirtliff M, Calhoun JH, Mader JT. Experimental Osteomyelitis Treatment with Antibiotic-Impregnated Hydroxyapatite. Clinical Orthopaedics and Related Research. 2002;401:239-47.

Reizner W, Hunter JG, O’Malley NT, Southgate RD, Schwarz EM, Kates SL. A systematic review of animal models for Staphylococcus aureus osteomyelitis. European Cells and Materials. 2014;27:196-212.

Reizner W, Hunter JG, O’Malley NT, Southgate RD, Schwarz EM, Kates SL. A systematic review of animal models for Staphylococcus aureus osteomyelitis. Eur Cells Materials. 2014;27:196-212.

Klenerman L. Historical Note. A history of osteomyelitis from the Journal of Bone and Joint Surgery 1948 to 2006. J Bone Joint Surg [Br]. 2007;89-B:667-70.

Mader JT, Shirtliff ME. The rabbit model of bacterial osteomyelitis of the tibia. In: Handbook of animal models of infection. Academic Press. 1999;581-91.

Mader JT, Shirtliff ME, Bergquist SC, Calhoun J. Antimicrobial Treatment of Chronic Osteomyelitis. Clinical Orthopaedics Related Research. 1999;360:47-65.

Swiontkowski MF, Hanel DP, Vedder NB, Schwappach JR. A comparison of short- and long-term intravenous antibiotic therapy in the postoperative management of adult osteomyelitis. J Bone Joint Surg [Br]. 1999;81-B(6):1046-50.