Venous Perfusion of the Limb with Antibiotics for Osteomyelitis and Other Chronic Infections

Abstract

A new approach to treatment of chronic infections of bone and soft tissue in limbs by perfusion is described. The method is based on a selective pressure technique; the antibiotic solution is introduced through an intravenous catheter distal to the focus of infection. Using a pressure dressing over the treated limb and a proximal tourniquet, the venous flow is shunted into the deep venous system and into the bone In some cases, surgical treatment was performed prior to the perfusion. The advantages of the method are: (1) simplicity and (2) delivery of effective antibiotics in high concentration to the infected region by diffusion through the infected or avascular scar tissue.

The method was used in fifteen patients with chronic infections of bone or soft tissue. Sufficient time has not elapsed to warrant final evaluation of the results, but in all the cases there was immediate control of the infection and sterile cultures were obtained. In three cases, recurrence was noted. Temporary results are discussed.