Evaluation of ozonated oxygen in an experimental animal model of osteomyelitis as a further treatment option for skull-base osteomyelitis

The standard treatment of chronic skull-base osteomyelitis is antibiotics a nd surgical removal of sequestrums. Hyperbaric oxygen therapy has been foun d to be a useful method for managing refractory cases of chronic osteomyeli tis. Since a minimal blood supply is needed for hyperbaric oxygen therapy, chronic osteomyelitis can produce necrotic infected areas that are not nutr ified and therefore not assessible for hyperbaric oxygen therapy. Ozone is known to be an oxidizing medium with a strong bactericidal effect. We inves tigated the influence of locally applied ozonated oxygen on the development of chronic osteomyelitis in an experimental animal model using the femur o f the rabble. The proximal sides of the femurs of 40 rabbits were prepared and a needle inserted into the intramedullary cavity. Osteomyelitis was ind uced with an infusion of Staphyloccus aureus and sodium morrhuate into the bone. The needle was left in a intramedullar location. After a 4-week delay animals were randomly separated into treatment and control groups. The inf ected femur of treated animals was flushed three times a day with 20 mi of ozonated oxygen at an ozone concentration of 107 mu g/ml O-2 over periods o f 2 or 4 weeks. Clinical, radiographic and microbiological findings were do cumented. Chronic osteomyelitis occurred in all animals. Ten rabbits were e xcluded from further study during the investigation because of excessive we ight loss (>15% of the original weight). Bacterial cultures showed no signi ficant reduction of S. aureus concentrations in the ozone-treated group, al though comparison of radiographic results revealed less serious osteomyelit is-related bone damage in these animals (P < 0.01). These findings indicate that refractory osteomyelitis in the head and neck may benefit from locall y applied "flush" therapy with ozonated oxygen in addtion to treatment with antibiotics, surgery and hyperbaric oxygen.