Nursing Management of Osteomyelitis

Nursing Management of Osteomyelitis

The affected area should be immobilized to reduce discomfort and prevent fractures. Can do warm saline baths for 20 minutes several times a day to increase the flow area.

Initial target of therapy is to control and stop the process of infection, blood and swab cultures and abscess cultures performed to identify the organism and choose the best antibiotic. Sometimes, infections caused by more than one pathogen.

Once the culture specimens were obtained, starting intravenous antibiotic therapy, assuming that the staphylococcus infection-sensitive semi-synthetic penicillin or cephalosporins. The goal is to control the infection before the blood flow to the area declined due to the occurrence of thrombosis. Continuous dosing of antibiotics appropriate time is crucial to achieve the levels of antibiotics in the blood are constantly high. Antibiotics are the most sensitive to the causative organism is given when known for culture and sensitivity. If the infection appears to have controlled, antibiotics can be given orally and continued until 3 months. To improve the absorption of oral antibiotics, do not be taken with food.

If the patient did not respond to antibiotic therapy, bone must be surgically exposed, purulent and necrotic tissue is removed and the area was accompanied directly with sterile physiological saline solution. But antibiotics are recommended.

In chronic osteomyelitis, an antibiotic adjuvant to surgical debridement. Do sequestrectomy (removal involucrum sufficiently so that the surgeon can lift sequestrum). Sometimes bone removal must be done to expose a deep cavity into a shallow basin (saucerization). All the bones and cartilage of infected and dead lifted so that can happen in a permanent cure.

The wound can be closed tightly to seal the cavity die (dead space) or installed tampon to be filled by granulation tissue grafting or done in the future. Can be mounted suction drainage, to control the hematoma, and dispose of debris. Can be given normal saline irrigation for 7 to 8 days. Infection can occur side by granting this irrigation.

The cavity in the debridement can be filled with cancellous bone graft to stimulate healing. In a very large defects, cavities can be filled by the transfer of blood vascular bone or muscle flup (where the muscle is taken from the surrounding tissue but with an intact blood vessels). Microsurgical techniques will increase the blood supply; improvement of blood supply would then allow bone healing and eradication of infection. This surgical procedure can be done in stages to ensure healing. Surgical debridement can weaken the bones, then require stabilization or advocate with internal fixation or external backers tool to prevent fractures.