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Surgery

Authoring team

Surgery should be postponed until there are significant symptoms combined with clear evidence of a sequestrum.

Sulphan blue is injected preoperatively; this stains all vital tissue green, leaving dead tissue unstained. Under antibiotic cover, the surgeon removes all dead i.e. unstained - tissues and bone.

There are several strategies to prevent reinfection and promote healing:

  • double lumen tubes are left in the lumen and antibiotic solution is introduced and aspirated 4 hourly; this is continued until the aspirate is sterile (3-6 weeks) and then the tube is gradually removed
  • the cavity may be packed with gentamicin beads
  • the cavity may be packed with multiple small bone grafts
  • a muscle flap with an intact blood supply may be laid into the cavity

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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