povidone-iodine and Osteomyelitis

Mediastinitis is one of severe and fatal complications after cardiac surgery, especially in the presence of a prosthetic graft. A 70-year-old male, who was suffered from chronic sternal osteomyelitis and mediastinitis after ascending aorta and hemiarch reconstruction was reported. He developed high fever and leucocytosis on the 16th postoperative day. Wound culture was positive for Grampositive organisms. He was diagnosed as having sternal osteomyelitis and mediastinitis and treated by sternal bone debridement and irrigation with dilute povidone iodine solution with no effects. Total excision of the infected sternum, irrigation with non-diluted solution of povidone iodine and omental transfer were performed successfully. The literature regarding omental transfer for mediastinitis and infected prosthetic grafts was briefly reviewed.

Topics: Aged; Aortic Aneurysm, Thoracic; Blood Vessel Prosthesis; Chronic Disease; Humans; Male; Mediastinitis; Omentum; Osteomyelitis; Povidone-Iodine; Prosthesis-Related Infections; Staphylococcal Infections; Staphylococcus epidermidis; Sternum; Therapeutic Irrigation

In recent years, the number of patients with ischemic skin ulcers due to diabetes mellitus and arteriosclerosis obliterans are increasing. Accordingly, endovascular therapy, drugs, and various wound dressings have been developed and applied to diabetic foot ulcers, and negative-pressure wound therapy, which often requires expensive and burdensome procedures for medical personnel, has also become popular. So simple and minimal invasive home treatment by the patient or their caregiver is required.. The present patient (77 years old, male, Asian) had developed left sole ulcers with draining pus that were resistant to conventional treatment, and he suffered from gait disturbance. We report a case of metatarsal osteomyelitis in a patient with diabetes mellitus and arteriosclerosis obliterans, in whom artificial carbon dioxide foot bathing and povidone-iodine sugar ointment were used continuously to promote bone and joint regeneration, and skin ulcer healing.. A simple therapeutic intervention with artificial carbon dioxide foot bathing and povidone-iodine sugar ointment can improve not only ischemic skin ulcers, but also the bone and joint regeneration of ischemic limbs. This therapy can lead to a reduction in healthcare costs for a huge number of diabetic patients.

Topics: Aged; Arteriosclerosis Obliterans; Carbon Dioxide; Humans; Male; Metatarsal Bones; Ointments; Osteomyelitis; Povidone-Iodine; Skin Ulcer; Sugars

The authors report a series of thirty-six perforating ulcers of the foot in diabetic patients, evaluated using M.R.I. M.R.I. showed osteomyelitis in 16 cases, cellulitis in 15 cases, osteoarthropathies in 21 cases, tenosynovitis of flexor tendons in 2 cases, oedema in 2 cases and abscess in one case. In 19 cases, M.R.I. was used to improve diagnostic accuracy. The medical treatment made use of thermo-moulded soles allowing for the recovery of walking, with a hole facing the perforating ulcer of the foot. The application of insulin-soaked sponges in the event of clean perforating ulcer of the foot and iodized solution in the event of infected perforating ulcer of the foot promoted healing. The treatment was only conservative, when the lesions were limited to the soft tissues. Surgical treatment was performed in 19 cases due to a global involvement of soft and osteoarticular tissues. In fourteen cases the surgical treatment was limited and was performed through the perforating ulcer. Resection of metatarsal heads or metatarso-phalangeal joints was performed in 10 cases, with resection of surrounding pathologic tissue. The surgical treatment was limited to the soft tissues in 6 cases. In 4 cases, M.R.I. findings resulted into a transmetatarsal amputation because the vascular plexus was of poor quality and infection spread from the perforating ulcer to the dorsal aspect of the foot. In our opinion, dorsal infectious involvement in a perforating ulcer of the foot, is a factor of poor prognosis. A below-knee amputation has been performed in one patient.

Topics: Abscess; Administration, Cutaneous; Adult; Aged; Amputation, Surgical; Anti-Infective Agents, Local; Bacterial Infections; Cellulitis; Diabetic Foot; Edema; Equipment Design; Follow-Up Studies; Foot Diseases; Humans; Hypoglycemic Agents; Insulin; Magnetic Resonance Imaging; Metatarsal Bones; Metatarsophalangeal Joint; Middle Aged; Osteoarthritis; Osteomyelitis; Povidone-Iodine; Prognosis; Shoes; Tenosynovitis; Walking; Wound Healing

An 8-month-old Holstein heifer was evaluated for right hind limb lameness of 3 weeks' duration. Diagnoses were osteomyelitis and fracture of the distal sesamoid bone, septic arthritis of the distal interphalangeal joint, and osteomyelitis of the third phalanx. After excision of a section of tissue from the plantar aspect of the digit and partial section of the deep digital flexor tendon, the distal sesamoid bone was excised. The third phalanx was curetted, and the surgical wound was lavaged. Twenty months after surgery, the heifer was fully weightbearing on the affected digit. Surgical exploration of the digit should be considered an alternative to claw amputation in cattle that have severe digital infections.

Topics: Animals; Cattle; Cattle Diseases; Curettage; Female; Fractures, Bone; Hindlimb; Lameness, Animal; Osteomyelitis; Povidone-Iodine; Sesamoid Bones; Therapeutic Irrigation

Fifty cases of chronic osteomyelitis were treated by closed, continuous, suction and irrigation and followed up for between six months and eight years. In group A, 25 cases were treated by irrigation with antibiotics, and in group B, 25 cases were treated by irrigation with Bitadine solution, irrespective of the culture and sensitivity reports. Appropriate antibiotics were given systemically. There was no notable difference in the results in the two groups, with an overall success rate of about 80%.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Child; Chronic Disease; Female; Humans; Male; Middle Aged; Osteomyelitis; Povidone; Povidone-Iodine; Suction; Therapeutic Irrigation

Experimental studies on dogs with staphylococcal osteomyelitis showed that it is possible to reduce florid bone suppuration by the use of hydroxyapatite granules containing an antibiotic or antiseptic. In our series the use of flucloxacillin hydroxyapatite granules was superior to other treatment methods. Twelve patients were treated with thorough sequestrectomy, reliable wound closure and suitable stabilization supplemented with an implant of antibiotic or antiseptic hydroxyapatite granules, and an autologous spongiosa graft for large bone cavities or for discontinuity between the bone ends. The results of this preliminary study showed the treatment to be effective.

Topics: Adolescent; Adult; Aged; Animals; Anti-Bacterial Agents; Anti-Infective Agents, Local; Bone Regeneration; Combined Modality Therapy; Dogs; Drug Implants; Durapatite; Female; Floxacillin; Fosfomycin; Humans; Hydroxyapatites; Male; Middle Aged; Osteomyelitis; Povidone-Iodine

Topics: Animals; Calcium Phosphates; Delayed-Action Preparations; Dogs; Femoral Fractures; Osteomyelitis; Povidone; Povidone-Iodine; Tibial Fractures; Wound Healing