Open wounds/ fractures

Microorganisms gain entry by way of blood

Microorganisms lodge into an area where circulation

slows

Microorganisms grow

Increase pressure

Vascular compromise of the periosteumIschemia

Infection through the bone cortex and marrow

Cortical devascularization

necrosis

Formation of new bone

Involcrum

Separation of devitalized bone from living bone Sequestra

Continues to be an infected island

Difficulty to reach by blood borne antibiotics

Enlarged sequestrum

Sequestrum move out to the soft tissue

revascularized

Removal by the normal immune process

Development of sinus tract

Turns to scar tissue

Site for continued microorganism growth

Remission and exacerbation

Chronic stage

Debridement

drainage from sinus tracts

fever, night sweats, chills, restlessness, nausea and malaiseconstant bone pain,

swelling, tenderness, warmth at the infection site,

restricted movement of the affected part

Systemic signs may be diminished with

constant bone pain, Swelling, tenderness, warmth at the infection

site

Excessive vascular insufficiency

Loss of organ function

Amputation

Healing

Predisposing factors:

vascular insufficiency disorders

genitourinary infectionsrespiratory infections

IV drug useimmunocompromising

diseaseshistory of blood- stream

infectionsIndwelling prosthetic

devices