Osteomyelitis

Osteomyelitis: A Patient's Guide to Bone Infection

Osteomyelitis is a serious infection of the bone that can occur in the foot and ankle. It can develop suddenly (acute) or persist as a long-term issue (chronic). Because bone has a limited blood supply compared to skin or muscle, these infections can be difficult to treat and require specialized medical and surgical intervention.

Causes and Risk Factors

Bone infections usually occur in one of three ways:

• Direct Entry: Bacteria entering the bone through a deep cut, a puncture wound (like stepping on a nail), or during a traumatic fracture.
• Bloodborne: Bacteria traveling through the bloodstream from an infection elsewhere in the body.
• Contiguous Spread: Infection spreading from nearby soft tissue or skin into the underlying bone.

The Connection to Diabetic Ulcers

The most common cause of osteomyelitis in the foot is a non-healing diabetic foot ulcer.

• Neuropathy: Diabetes often causes nerve damage, meaning a patient may not feel a small wound on the bottom of their foot.
• Poor Circulation: Reduced blood flow makes it harder for the body to fight off surface
• The "Probe-to-Bone" Rule: If a diabetic ulcer is deep enough that a medical professional can feel bone at the base of the wound, there is a very high probability that osteomyelitis is present.

Treatment Options

1. Conservative (Non-Surgical) Management

In very early cases or when surgery is too risky, doctors may attempt conservative care:

• Long-Term Antibiotics: Typically 6 to 12 weeks of high-dose antibiotics, often delivered intravenously (IV) through a PICC line.
• Offloading: Using a walker boot to ensure no pressure is placed on the infected
• Wound Care: Specialized dressings and frequent cleaning to help the skin ulcer

2. Traditional Surgical Treatment

If the infection is deep or the bone has begun to die (necrosis), surgery is necessary:

• Debridement: The surgeon removes the infected or dead portion of the
• Amputation: Historically, if a large section of bone was infected, a partial or full amputation was often the only way to stop the infection from spreading to the rest of the

A New, Limb-Sparing Approach: CERAMENT G

Traditional surgery often leaves a "dead space" or a hole in the bone after the infection is removed. This void can easily become re-infected. Our practice utilizes CERAMENT G, a breakthrough technology designed for limb salvage and preservation.

What is CERAMENT G?

CERAMENT G is an injectable, bioactive bone substitute that contains Gentamicin, a powerful antibiotic.

Why it is a Game-Changer:

• Targeted Infection Control: It delivers high concentrations of antibiotics directly into the bone where they are needed most, avoiding many of the side effects of long-term IV
• Fills the Void: It acts as a scaffold, filling the hole left by the removed
• Bone Regeneration: As the antibiotic is slowly released, the material is absorbed by your body and replaced with your own healthy, living bone.
• Minimally Invasive: It can be injected or packed into the bone during a single surgical procedure, often reducing the need for multiple follow-up surgeries.

Patient Outcomes & Expectations

Using advanced limb-sparing technologies like CERAMENT G has significantly changed the outlook for patients with chronic bone infections.

Recovery and Success

Recovery from osteomyelitis is a journey that requires a team approach involving your surgeon, an infectious disease specialist, and often a wound care expert.

• Early Detection: The faster an infection is identified via MRI or bone biopsy, the better the chance of saving the limb.
• Compliance: Following weight-bearing restrictions and completing all prescribed medications is vital to prevent the infection from returning.

Schedule an appointment with Dr Sandhu today to discuss your options!

2120 N. MacArthur Blvd
Irving, TX 75061
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