What is the recommended treatment approach for sternum osteomyelitis?

What is the recommended treatment approach for sternum osteomyelitis?

• A. Antibiotics, Open Drainage, Resection And Debridement With Reconstruction Using Muscle Flap Or Omental Flap
• B. Antibiotics Alone
• C. Observation
• D. Radiation Therapy

Answer: (A)

Sternal osteomyelitis requires both definitive source control and restoration of the chest wall with well-vascularized tissue. Infected sternum and surrounding necrotic tissue are often poorly perfused and can harbor biofilm, so antibiotics alone rarely eradicate the infection. The best approach combines systemic antibiotics with aggressive surgical management: open drainage and debridement (and, if needed, resection of all necrotic bone) to remove the infectious nidus, followed by reconstruction using a vascularized tissue transfer such as a muscle flap or an omental flap. This reconstruction fills dead space, delivers a robust blood supply to the area, and helps prevent recurrent infection while restoring chest wall stability. Radiation therapy is not a treatment for infection, and observation or purely medical management without source control tends to fail in sternum osteomyelitis.

Sternal osteomyelitis requires both definitive source control and restoration of the chest wall with well-vascularized tissue. Infected sternum and surrounding necrotic tissue are often poorly perfused and can harbor biofilm, so antibiotics alone rarely eradicate the infection. The best approach combines systemic antibiotics with aggressive surgical management: open drainage and debridement (and, if needed, resection of all necrotic bone) to remove the infectious nidus, followed by reconstruction using a vascularized tissue transfer such as a muscle flap or an omental flap. This reconstruction fills dead space, delivers a robust blood supply to the area, and helps prevent recurrent infection while restoring chest wall stability. Radiation therapy is not a treatment for infection, and observation or purely medical management without source control tends to fail in sternum osteomyelitis.