Keep it Clean! Osteomyelitis

By Roberta Palmer, RN and Patty Kunze, BSN, RNC


OSTEOMYELITIS…. we hear this term frequently in our spinal cord injury community but do we know what it really means? Osteomyelitis is an infection of the bone, a rare but serious condition. Bones can become infected in a number of ways: Infection in one part of the body may spread through the bloodstream into the bone, or an open fracture or surgery may expose the bone to infection. Stay with us now, this is a short article. Down and dirty, quick information.



WHAT CAUSES OSTEOMYELITIS?

Usually a bacterium caused staph aureus causes osteomyelitis. Staph is a common bacterium that may live on skin or in the noses of some but it doesn’t cause an infection. When staph minds it’s own business on the skin, life is good. But when a wound is open bacteria can enter and wreak havoc. There are several strains of staph. You will hear the term MRSA, which is Methicillin Resistant Staph Aureus, meaning that form of staph doesn’t respond to Methicillin antibiotics. That’s why we have to be so careful with our skin and our skin tears or sores. They can allow staph to enter, and then we have a problem. Also, be aware that certain conditions that weaken the body’s immune system can increase a person's risk for osteomyelitis. This includes people with diabetes. (So keep an eye on those feet!)




TREATMENT FOR OSTEOMYELITIS
Treatment starts with antibiotics. (The Rollin’ RNs penned another article on Antibiotic Resistance.) Staying ahead of issues pertaining to spinal cord injury is such a slippery slope for us. We need antibiotics to work immediately when we require them. If antibiotics are not working then surgery may be recommended. Surgery removes the infection of tissue and bone from spreading faster. If the osteomyelitis is not treated quickly, amputation may result and we don’t want to get to that point. Another set back to not treating osteomyelitis quickly is that it can become a chronic condition. Once chronic osteomyelitis is established, the person affected may have periods of almost no symptoms. However, symptoms can flare up at any time. If you have chronic osteomyelitis, make sure your doctor knows about your medical history so you can work together to keep the condition under control.


PREVENTION OF OSTEOMYELITIS
Keep it clean. Simple as that. Meticulous skin inspection and care. The presence of osteomyelitis should be considered in every patient with a wound that does not heal. That will require a culture and/or biopsy for correct lab determination. Remember, final lab cultures take 72 hours to be complete. So, results will not be immediate.
Bottom line– take immediate action for your own body. Be proactive if your skin receives a tear or sore to avoid this complication. You do not want to learn firsthand about osteomyelitis.

It’s all good, so keep on rollin’.
Patty, BSN, RNC and Roberta, RN
The Rollin’ RNs ™

References:
https://www.ncbi.nlm.nih.gov/pubmed/6703888
https://www.webmd.com/diabetes/osteomyeltis-treatment-diagnosis-symptoms#1
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About the Authors:


Patty Kunze has been a Registered Nurse since 1983. She holds a Bachelor’s of Science Degree in Nursing and worked several years in a Spinal Cord Injury Unit at the local Veterans Administration Medical Center as a new graduate. She has been a flight transport nurse for Neonatal Intensive Care, an assistant manager of Labor and Delivery, and an instructor of nursing students. In 2009, she was involved in an auto accident which left her paralyzed (T3-4 complete paraplegic) from the chest down. But she continues her nursing career while sitting in her wheelchair as a nurse paralegal and writing articles for others with spinal cord injuries as The Rollin RN ™.




Roberta Palmer has been a Registered Nurse for 20 years.  She has knowledge in Family Practice, Allery and Immunology, Special Pharmacy Medication and Counseling, and she is a RN Health Coach. In 2014, she was involved in an ATV accident which also left her paralyzed (T3-4 complete paraplegic) from chest down.



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