Management of Chronic Osteomyelitis Following Gunshot Injury: A Systematic Review of Literature

Abstract

This systematic review of 5 studies was performed to assess the different ways of management chronic osteomyelitis following gunshot injuries. Three of them are retrospective and two are prospective without control group. All the patients were adult group and they had long bone chronic infection mainly femur and tibia. Most of the patients were diagnosed by laboratory, radiography, and tissue culture and sensitivity. Mixed bacterial organisms often cause the war osteomyelitis. In our systematic review, 169 patients (60%) were infected by staphylococcus aureus, 38 patients (16%) were infected by Mixed bacterial organisms and 57 patients (24%) were infected by other kinds of bacterial usually Pseudomonas. Most of patients were classified as Gaustilio type lllB and Cierny Mader type lllB. All the patients in our study were undergone radical surgical debridement before the fixations to eradicate the infection from the bone and soft tissue. 89% of patients treated by systemic and local antibiotics according to culture and sensitivity of infected bone combined with external fixation while 11% of patients treated without antibiotic. Systemic antibiotics were continued for 4 weeks intravenously and 4-6 weeks orally at home. 91% of patients were treated by one stage operation while 9% of patients were treated by two stages operation. Soft tissue coverage was done in 23% of patients. In our study, Ilizarov external fixator was used in treatment of most cases with bone defect. The mean bone