ABSTRACTS *

Osteomyelitis beneath pressure sores . Sugarman B, Hawes S, Musher DM, et al. Arch Intern Med 143: 683, 1983 (21 references) Sometimes pressure sores fail to heal despite aggressive treatment. When that occurs, clinicians need to seek underlying contributing disorders. Sugarman et al. prospectively evaluated pressure sores that had not healed after two weeks of therapy. Osteomyelitis was associated with nine of 28 lesions, and “pressure‐related” bone changes were present in 14. The authors stress the use of radiographs and nuclear medicine scanning in the diagnosis of osteomyelitis; but they also caution that the diagnosis can be made with certainty only by histologic examination. When possible, antimicrobial therapy should be based on microbial culture of bone tissue and susceptibility testing of suspected organisms. Clearly, when pressure sores fail to heal as expected, osteomyelitis should be considered.