Treatment of Bone, Skin & Wound Infections
Treatment of Bone Infections
Bone infections (osteomyelitis) occur when various types of bacteria travel through the bloodstream and spread to the bone or when an open wound over the bone leaves it exposed to bacteria.
Mild bone infections are first treated with a surgical procedure that serves to clean out the bone. Since the bone can be accessed by a variety of approaches, an orthopedic surgeon specializing in bone infection can determine which approach is the most appropriate to use.
Locally administered antibiotics are then administered in one of two ways. One option is to use nonresorable bone cement that requires subsequent surgery for removal and replacement with bone graft. The second option employs an absorbable mix of synthetic bone substitute, which does not require any subsequent surgery. Antibiotic therapy is then required for four to six weeks in order to ensure that all remaining bacteria in the bone and bloodstream have been destroyed. This may be administered orally or through an intravenous catheter depending upon laboratory results from surgical samples of the bacteria that infected the bone.
As with mild bone infection, severe bone infection is first treated with a surgical cleansing procedure, followed by the administration of local antibiotics. With severe infection, after bone cleaning takes place, the bone is not strong enough to bear weight. Several techniques are available to then begin rebuilding the bone. These include bone grafting or bone transport, which is achieved with the use of a special apparatus called the Ilizarov external fixator. This may remain in place for several months, depending on how much of the bone was lost due to the infection
Treatment of Skin Infections
There are a wide variety of skin and soft tissue infections. The most important step in treating a skin infection is determining whether there is only a local response (concentrated in one specific area) or if there is systemic involvement (distributed throughout the body).
Treatment includes appropriate antibiotics, drainage of pus collections, debridement, removal of foreign bodies such as stitches that may be a focus of infection, and treating an underlying skin disease such as eczema.
There are different options for antibiotics depending on the type of skin infection you have:
- Topical antibiotics such as Mupirocin, Neomycin, Polymyxin, and Bacitracin effectively treat superficial skin infections such as impetigo and dermatitis, as well as secondarily infected traumatic lesions such as suture wounds, lacerations, and abrasions.
- Systemic antibiotics such as Penicillin, Clindamycin, Dicloxacillin, Cephalexin, Doxycycline, Minocycline, Trimethoprim-sulfamethoxazole, and Vancomycin are used to treat complicated skin infections. Complicated, severe soft tissue infections can be indicated by pain disproportionate to physical findings, violaceous bullae, cutaneous hemorrhage, skin sloughing, skin anesthesia, rapid progression, and gas in the tissues.
- Prophylactic antibiotics may also be administered before a surgery in order to prevent an infection.
Treatment of Wound Infections
Wound infections occur when bacteria enters through a break in the skin and attaches to the tissues, thus halting the wound healing process. Deep ulcers (open sores), severe burns, and bite wounds are the most likely to get infected. However, wound infection can also take place in puncture wounds (holes), lacerations (tears), incisions (cuts), and smaller wounds and burns that are left untreated.
Treatment of wound infection is dependent upon the length of time you have been suffering from the infection, the severity and location of the wound, and whether other areas have been affected. Treatment options include the following:
- Cleansing: Rinsing the wound with clean water and/or germ-killing solutions
- Debridement: This process serves to clean and remove objects, dirt, or dead skin and tissues from the wound region. After cutting out damaged areas in or around the wound, the wound may be drained to remove pus before wet or dry dressings are applied.
- Medicines: Antibiotic medications may be given to fight infections. In addition, some medicines are prescribed to decrease pain, swelling, or fever experienced as a result of the infection.
- Other Treatments: Your doctor may choose to control or treat the medical condition that is causing the wound infection. For example, a medication may be prescribed to control diseases such as diabetes or high blood pressure. Surgery may also be performed to increase blood flow in the event that you are experiencing blood vessel problems.
- Lifestyle Changes: Special diets, supplements (such as Vitamin C which promotes wound healing), and quitting smoking are lifestyle changes your doctor may suggest in order to fight infection and facilitate wound healing.