Articles | Volume 7, issue 3
https://doi.org/10.5194/jbji-7-127-2022
© Author(s) 2022. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
https://doi.org/10.5194/jbji-7-127-2022
© Author(s) 2022. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
Osteocutaneous-flap-related osteomyelitis following mandibular reconstruction: a cohort study of an emerging and complex bone infection
Clément Javaux
Department of Infectious Diseases, Groupement Hospitalier Nord,
Hospices Civils de Lyon, Lyon, 69004, France
Regional Reference Center for the Management of Complex Bone and Joint
Infections, Hospices Civils de Lyon,
Lyon, 69004, France
Clémentine Daveau
Department of Otolaryngology Surgery, Groupement Hospitalier Nord,
Hospices Civils de Lyon, Lyon, 69004, France
Clotilde Bettinger
Department of Anesthesiology, Groupement Hospitalier Nord, Hospices
Civils de Lyon, Lyon, 69004, France
Mathieu Daurade
Department of Oral and Maxillofacial Surgery, Groupement Hospitalier
Nord, Hospices Civils de Lyon, Lyon, 69004, France
Céline Dupieux-Chabert
Regional Reference Center for the Management of Complex Bone and Joint
Infections, Hospices Civils de Lyon,
Lyon, 69004, France
Laboratory of Bacteriology, Institute of Infectious Agents, Groupement
Hospitalier Nord, Hospices Civils de Lyon, Lyon, 69004, France
Centre International de Recherche en Infectiologie (CIRI), Inserm,
U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale
Supérieure de Lyon, Lyon, 69007, France
Fabien Craighero
Department of Radiology, Groupement Hospitalier Nord, Hospices Civils
de Lyon, Lyon, 69004, France
Carine Fuchsmann
Department of Otolaryngology Surgery, Groupement Hospitalier Nord,
Hospices Civils de Lyon, Lyon, 69004, France
Philippe Céruse
Department of Otolaryngology Surgery, Groupement Hospitalier Nord,
Hospices Civils de Lyon, Lyon, 69004, France
Arnaud Gleizal
Department of Oral and Maxillofacial Surgery, Groupement Hospitalier
Nord, Hospices Civils de Lyon, Lyon, 69004, France
Nicolas Sigaux
Department of Oral and Maxillofacial Surgery, Groupement Hospitalier
Sud, Hospices Civils de Lyon, Pierre-Bénite, 69310, France
Tristan Ferry
Department of Infectious Diseases, Groupement Hospitalier Nord,
Hospices Civils de Lyon, Lyon, 69004, France
Regional Reference Center for the Management of Complex Bone and Joint
Infections, Hospices Civils de Lyon,
Lyon, 69004, France
Centre International de Recherche en Infectiologie (CIRI), Inserm,
U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale
Supérieure de Lyon, Lyon, 69007, France
Florent Valour
CORRESPONDING AUTHOR
Department of Infectious Diseases, Groupement Hospitalier Nord,
Hospices Civils de Lyon, Lyon, 69004, France
Regional Reference Center for the Management of Complex Bone and Joint
Infections, Hospices Civils de Lyon,
Lyon, 69004, France
Centre International de Recherche en Infectiologie (CIRI), Inserm,
U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale
Supérieure de Lyon, Lyon, 69007, France
A full list of authors appears at the end of the paper.
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Subject: Osteomyelitis | Topic: Other
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Cancerous transformation is a rare but potentially life-threatening complication of chronic bone infection. As with all forms of cancer, early detection and diagnosis is crucial to outcome.
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Bone infections are challenging to treat and require new treatments. The current animal models for testing new therapies can be expensive and complex; therefore, we developed a cheap and reliable bone infection model in mice. Our new model features an infected hole created by a needle in the leg bone with a metal pin. This method achieved a consistent infection rate and demonstrates the importance of bacterial biofilm in bone infection.
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Short summary
We describe 48 osteocutaneous-flap-related osteomyelitis cases, mostly presenting with early, local signs of infection and/or bone exposure. Main pathogens were Gram-negative bacilli, streptococci, S. aureus, enterococci, and anaerobes, justifying a broad-spectrum empirical antimicrobial therapy. Despite surgery and a 3-month antimicrobial therapy, a 50 % failure rate was recorded, associated with a delayed infectious disease specialist referral and advocating for multidisciplinary management.
We describe 48 osteocutaneous-flap-related osteomyelitis cases, mostly presenting with early,...