Osteomyelitis

Is an infection of the bone which can either be acute or chronic, bacteria are the usual infections agents. The two likely access method are by primary infectious of the bloodstream ( including secondary to infections via the blood following in infection somewhere else in the body. In adults pelvis and spinal are the most vulnerable while bone infection in children tend to target the bones of the arms and legs.

Sign/ Symptoms
 Localized pain  Reduced movement of the affected body part  Overlying skin maybe red hot and swollen  Overlying skin may occur contain pus  Unexplained weight loss  General malaise  Increase Temperature  Increase sweating  Chills

Causes:  Bacteria introducing during bone surgery  Bacteria ibtroducing by trauma to bone  Infection of bone fracture  Infection of prosthetic implants  Infection of the blood ( septicemia)

Pathophysiology
Precipitating factors  Traumatic injury  Poorly nourished  Obese  Engaged to extraneous activities  Impaired immune  Bacteria invasion: S. aureus  Inflammation  Growth of organism  Thrombosis of the blood vessels  Decrease oxygen supply and nutrition  Open/ close Ischemia

 Infections extends to medullary cavity and under the perosteum

 Abscess formation. Dead bone tissue  Sequestrum  Involucrum  If untreated increase fever,rapid pulse  OSTEOMYELITIS > sudden onset of chills,

Diagnostic Test

>Physica Examination > Medical History >Blood Test > X-rays >Bone Scan ( Radio Nuclide) >CT- Scan >MRI >Bone Tissue Biopsy Blood culture

Medical Management
Initial goal of therapy is to control and helt the infective process. Antibiotic therapy depends on the results of blood and wound cultures. Frequently the infection is caused by more than one pathogen. General supportive measure (ex. Hydration, diet in high Vitamins and protein, corrective. of anemia0 should be instituted the area affected with osteomyelitis is immobilized to soak for 20 minutes. Several times a day be prescribed to increased circulation to the affected area.

1. Cauterization 2. Debridement 3. Sequestrectomy 4. Skin Grafting 5. Huntington Ostomy 6. Amputation

Nursing Management
1. Use strict aseptic technique when changing dressing and irrigating wounds.

2. Provide diet high in protein and Vit. C. 3. Assess V/S and wound dressing appearance daily and monitor daily for new pain. 4. Support the affected limbs with from pillows. 5. Provide good cast care. 6. Protect the patient from mishaps. 7. Be alert of sudden pain, crepitus and deformity. 8. Provide emotional support and appropriate diversions.

Treatment

Intravenous and Oral Anti- Biotics surgical drining and cleaning of the affected bone.

Refference: Book in Orthopedic

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