Definition and Causes
Osteomyelitis is a bone infection. Infection may spread to bone from surrounding soft tissue, from elsewhere in the body via
the blood, or directly from a bone injury or bone surgery. Osteomyelitis is a serious complication of
chronic wounds
and
necrotizing infections
and is a distinctive feature of Wagner Grade 3
diabetic ulcers.
Bone infections may be caused by any number of bacteria or fungi. The most common cause of osteomyelitis is MRSA, or
methicillin-resistant Staphylococcus aureus, which has become a particularly troublesome hospital- and healthcare-acquired
infection (HAI). Actinomycosis, or lumpy jaw, a disease common in animals but rare in humans, may be caused by bacteria of
the Actinomyces species or by other anaerobic pathogens. Blocked vessels (ischemia) or poor circulation of oxygenated blood
in and around infected bone may lead to inflammation (osteitis), abscess (pus), swelling (edema), pressure
(compartment syndrome),
and death (necrosis) of soft and bony tissue.
Hyperbaric Oxygen Approval Status
Read the
Osteomyelitis (Refractory)
page in the Undersea and Hyperbaric Medical Society resource library to learn more about persistent or recurring bone
infections, the rationale for hyperbaric oxygen therapy, and treatment protocols, key clinical evidence, and success factors.
Treatment with Hyperbaric Oxygen Therapy
Hyperbaric oxygen therapy (HBOT) is an effective adjunct to antibiotics and surgery, the traditional treatments for
osteomyelitis. When the bacteria involved are anaerobic, meaning they thrive in low-oxygen environments, hyperbaric oxygen
kills them and stops them from replicating, spreading, and releasing damaging toxins. HBOT may also improve circulation,
boost the effect of antibiotics, deliver infection-fighting blood components to the infection site, and accelerate bone
growth and healing.
hyperbariclink commentary
Hyperbaric oxygen can be a potent bactericide and also treats the hypoxia at the root of osteomyelitis and surrounding
soft tissue necrosis. The approved clinical indication is limited to refractory (persistent or recurring) bone infections
that do not respond to accepted surgical and antibiotic treatment.
UHMS
guidelines recommend daily treatments of 90-120 minutes at 2.0-3.0 atmospheres of absolute pressure (ATA), starting soon
after surgical debridement and continuing 4 to 6 weeks. Osteomyelitis, like necrotizing infections, involves some rather
frightening germs. As antibiotics and other traditional weapons against these worrisome microscopic invaders begin to
weaken, HBOT provides a vital backstop.
Patient Resources
HyperbaricLink recommends the following websites for anyone seeking authoritative information, patient advocacy, and community
support for osteomyelitis.
AAOS is a world-leading provider of musculoskeletal training and education for orthopaedic surgeons. The academy's
orthopaedic connection
website offers thorough and trustworthy patient information on bone disease, injury, treatment, and rehabilitation, with separate pages on
Infections
and
Bone, Joint, and Muscle Infections in Children.
A service of the US National Library of Medicine and the National Institutes of Health, MedlinePlus offers plenty of helpful
links from its easy-to-read article on bacterial infections.
Another service of the US National Library of Medicine and the National Institutes of Health, PubMed Health offers a shorter
page (with lots of links) on osteomyelitis.
HHS.gov offers healthcare professionals and patients and families an excellent interactive video program,
Partnering to Heal
about preventing healthcare-associated infections (HAIs).
Clinical Resources
Start with the following resources to explore current research activities and the peer-reviewed medical literature on
hyperbaric oxygen therapy for osteomyelitis.
ClinicalTrials.gov keeps the official list of human clinical trials currently enrolling, in progress, and recently completed.
One may reasonably question the size and legitimacy of any study not listed here.
Search ClinicalTrials.gov for current studies of hyperbaric oxygen therapy and osteomyelitis
A specialized Google search engine, Google Scholar indexes scholarly articles, patents, and legal opinions and journals.
Google Scholar may generate excessive search results, but entries provide easy access to full-text journal articles.
Search Google Scholar for osteomyelitis and hyperbaric oxygen
The IDSA provides information, education, and practice guidelines for physicians, scientists, and other healthcare
professionals who specialize in infectious diseases.
The MRSA Research Center is a leader in clinical and laboratory research and the go-to information resource for infection
control professionals and people affected by methicillin-resistant Staphylococcus aureus.
PubMed.gov
US National Library of Medicine
National Institutes of Health
PubMed keeps the official list of scientific papers published in reputable peer-reviewed medical journals. One may reasonably question the importance and
legitimacy of any study not listed here.
Search PubMed.gov for journal articles relating to hyperbaric oxygen therapy and osteomyelitis
HHS.gov offers healthcare professionals and patients and families an excellent interactive video program,
Partnering to Heal
about preventing healthcare-associated infections (HAIs).
Related Terms
- Abscess
- Actinomyces
- Actinomycosis
- Antibiotic
- Bacteria
- Bony necrosis
- Chronic wounds
- Compartment syndrome
- Diabetic ulcers
- Drug-resistant staph
- Edema
- Healthcare-acquired infection (HAI)
- Hospital-acquired infection (HAI)
- Hypoxia
- Ischemia
- Lumpy jaw
- Methicillin
- MRSA
- Mycobacteria
- Necrosis
- Necrotizing infections
- Nosocomial infection
- Osteitis
- Osteogenesis
- Pycogenic bacteria
- Soft tissue infections
- Staphylococcus aureus
- Wagner grade scale