Abstract

CARABELLI, Guido et al. Tratamiento de la osteomielitis asociada a úlceras alrededor de la pelvis. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2018, vol.83, n.4, pp.248-255. ISSN 1852-7434.

Introduction: Treatment of chronic osteomyelitis secondary to pressure ulcers around the pelvis is complex and multidisciplinary. Antibiotic treatment, usually aimed at more than one microorganism, in addition to surgery would reduce the recurrence of infection. The goal of this study was to analyze results in patients with pressure ulcer-related osteomyelitis around the pelvis, being treated with debridement and a flap to cover the soft tissue defect. Methods: A descriptive, retrospective study was carried out with data obtained from medical records of patients requiring surgical coverage of pressure sores, between October 2010 and February 2017. Patients were treated in two surgical times: debridement and then a flap to fill the remaining soft tissue defect. Results: Twenty-seven pressure ulcers were treated (sacral 9, ischial 13, trochanteric 5) in 15 patients (average age 44. 9 years [range 22-81]). Only a single microorganism was detected in three ulcers, the remaining ulcers developed more than one microorganism. Intravenous antibiotics for at least 4-6 weeks were administered. Initially erythrocyte sedimentation rate and ultrasensitive protein C reactive values were 72 mm/h and 55 mg/L, respectively, after three months of flap surgery, and they decreased to 49 mm/h and 20 mg/L, respectively. Conclusions: Our protocol reduces length of treatment, since we do not wait until the cessation of antibiotics to perform the flap. We consider that soft tissues defect coverage as soon as possible reduces colonization of new microorganisms in the involved region. We obtained good results with a low recurrence rate compared to other series.

Keywords : Osteomyelitis; Pelvis; Pressure ulcer.

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