Chronic osteomyelitis - The effect of the extent of surgical resection on infection-free survival

We studied prospectively a consecutive series of 50 patients with chronic o steomyelitis. Patients were allocated to the following treatment groups: 1) wide resection, with a clearance margin of 5 mm or more; 2) marginal resec tion, with a clearance margin of less than 5 mm; and 3) intralesional biops y, with debulking of the infected area. All patients had a course of antibi otics, intravenously for six weeks followed by orally for a further six wee ks. No patients in group 1 had recurrence, In patients treated by marginal resection (group 2), 8 of 29 (28%) had recurrence. All patients who had deb ulking had a recurrence within one year of surgery. We performed a survival analysis to determine the time of the recurrence of infection. In group 2 there was a higher rate of recurrence in type-B hosts (p < 0.05); no type-A hosts had recurrence. This information is of use in planning surgery for c hronic osteomyelitis.