Chronic Osteomyelitis Treatment — NDEB AFK MCQ
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Correct answer: A — Prolonged antibiotic therapy (4-6 weeks minimum) combined with surgical debridement (sequestrectomy, decortication, saucerisation)
Chronic osteomyelitis of the mandible requires both prolonged antibiotic therapy (typically IV antibiotics initially transitioning to oral for a total of 4-8 weeks) AND surgical debridement. Surgery involves removal of sequestra (dead bone fragments), decortication (removal of cortical bone to improve vascularity), and saucerisation (creation of a shallow, open wound). The combination approach addresses both the infection (antibiotics) and the avascular necrotic bone that harbours bacteria and prevents antibiotic penetration (surgery). Hyperbaric oxygen may be used as an adjunct.
Reference: Hupp – Contemporary Oral and Maxillofacial Surgery, 7th ed., 2019