Lautenbach Irrigation System

Osteomyelitis is infection of bone and frequently seeds in trabecular areas affecting both bone and bone marrow. Bone infection differs from soft-tissue infection since bone consists of a collection of rigid compartments. Bone is thus more susceptible than soft tissues to vascular damage and cell death due to pressure in acute inflammation. Unless it is rapidly suppressed, bone infection will inevitably lead to necrosis. Chronic infection is seldom eradicated by antibiotics alone. Yet bactericidal drugs are important to suppress the infection and prevent its spread to healthy bone and to control acute flares. The choice of antibiotic depends on microbiological studies, but the drug must be capable of penetrating sclerotic bone and should be non-toxic with long-term use. A different technique is the Lautenbach approach, involving radical excision of all avascular and infected tissue followed by closed irrigation and suction drainage, and an appropriate antibiotic solution in high concentration to allow the 'dead space' to be filled by vascular granulation tissue.