COMPLEX REHABILITATION OF PATIENTS WHO SURVIVED ACUTE HEMATOGENOUS OSTEOMYELITIS

Abstract

Until recently, only findings of local status and laboratory diagnostics were used as objective tests which defined terms and volume of therapeutic and preventive measures for clinical examination of patients who survived acute hematogenous osteomyelitis. The prescribed complex treatment does not take into account the following indexes: patient’s co-morbidity which is characterized by the autonomic reactivity; presence of stigmas of the connective tissue dysplasia, trophic status as well as psychological characteristics of patients. During the present study, connective tissue dysplasia was revealed in 70% of patients who had acute hematogenous osteomyelitis what was confirmed by the revealed phenotypic signs and biochemical blood markers. While assessing trophic status, a disharmonious body type and insufficient physical development were seen in patients who survived septic-pyemic form of the disease. Patients who had acute hematogenous osteomyelitis, even in the absence of markers of active inflammatory process, demonstrated signs of impaired adaptation-compensatory mechanisms involving the humoral regulation and a wide range of psychological problems which reflect tension of systems and play an important role in self-development and self-maintenance of the pathological process - the so-called principle of pathoautokinesis. Patients who survived hematogenous osteomyelitis, especially in the septic form, should continue their rehabilitation, have follow-up examinations and anti-relapse treatment. In this group of patients, multidisciplinary approach is needed for developing their rehabilitation program. Terms of this program should be individualized and defined by the normalizing of objective indicators (local status and comorbid conditions).