Using the Existing Periosteum in the Treatment of Chronic Osteomyelitis in the Pediatric Age Group

Background: The treatment of chronic osteomyelitis definitely needs a proper medical and surgical treatment, such as antimicrobial therapy according to established guidelines, and requires surgical intervention such as debridement and/or drainage, which has become particularly important in the last decade owing to the continued emergence of Community-acquired methicillin-resistant staph aureus (MRSA) which is resistance to all the β-lactam antibiotics. Methods: This is a retrospective study where we analyzed 23 cases of community-acquired MRSA chronic osteomyelitis presented to our orthopedic and trauma clinic at royal rehabilitation center between 2013-2021; All cases were started with broad-spectrum antimicrobial therapy, which is Vancomycin in addition to TMP–SMX or Rifampicin and multiple surgical debridements with removing all devitalized bone and the infected soft tissues and drainage procedures with preserving the thick periosteum were done in all cases. We used both the erythrocyte sedimentation rate (ESR) and the C -C-reactive protein (CRP) as acute inflammatory markers, which were checked twice weekly to monitor the outcome of the patients. Conclusion: MRSA osteomyelitis in the pediatric age group can be treated appropriately with surgery, which is the mainstay of therapy and antibiotic treatment based on international guidelines.