Bioactive glass in the treatment of chronic osteomyelitis in children: Description of four consecutive cases and literature review

Introduction: Chronic osteomyelitis in children is a rare condition. Debridement surgery, along with ap-propriate antibiotic therapy, is widely agreed to represent the best procedure in the treatment of chronic osteomyelitis but can result in an extensive dead space formation. In this study, we evaluated the use of bioactive glass to address dead space management.Methods: Four consecutive cases of chronic osteomyelitis treated with antibiotic therapy, one stage- sur-gical debridement and bioglass implantation between September 2016 and February 2017 were prospec-tively followed for a minimum of three years. Two cases followed acute hematogenous osteomyelitis, two cases followed fracture fixation. Clinical, histology, laboratory and radiographic findings were recorded. Primary endpoint was eradication of infection. Possible complication related to bioglass application were investigated.Results: All patients achieved healing at the latest follow-up of minimum three years. No successive surgical treatments were required at any time. No complications related to the bioglass were detected. Radiographic reconstruction of normal anatomy progressed through the years.Conclusions: Bioglass for the treatment of dead space after surgical debridement appears a viable option in the treatment of chronic osteomyelitis in children.(c) 2022 Elsevier Ltd. All rights reserved.