백서 하악골 골수염의 감염세균에 대한 고압산소요법의 억제효과에 관한 연구

Experimental study on the antimicrobial effect of hyperbaric oxygen therapy on the microorganisms of the mandibular ostemyelitis in albino rats

The main objective of this study was to observe the antimicrobial effect of hyperbaric oxygen therapy (HBO) on the infected microorganisms, aerobic and anaerobic, of the mandibular osteomyelitis in Albino rats. The experimental osteomyelitis was induced by formation of bone hole into the medullary cavity and inoculation of Staphylococcus aureus as aerobic microorganism, and Bacteroides melaninogenicus as anaerobic microorganism separately. Author used 170 rats (Sprague-Dawley strain) dividing into a pilot study (30), aerobic osteomyelitis (80) and anaerobic osteomyelitis (60) groups. In aerobic osteomyelitis caused by S. aureus, the treatment regimen consisted of HBO (2hrs, daily at 2.4 atm.), cephalexin, a combination of both and/or no treatment control group, and in anaerobic osteomyelitis caused by B. melaninogenicus, the treatment regimen consisted of HBO once a day, HBO twice a day and/or no treatment control group, and the results were compared microbiologically. The obtained results were as follows; 1. In vitro study, hyperbaric oxygen therapy (HBO) on Staphylococcus aureus has no direct bacteriostatic effect compared with control group in ambient air, due to similar bacterial growth, and combination of HBO and antibiotic therapy revealed similar antimicrobial effect compared with antibiotic therapy alone. 2. In treatments on experimental osteomyelitis caused by Staphylococcus aureus, HBO is at least as effective as antibiotic therapy, and no significant difference was revealed between HBO group and a combination of HBO and antibiotic therapy group statistically. 3. In vitro study, antimicrobial effect of HBO on Bacteroides melaninogenicus revealed statistical significant difference compared with control group, and HBO twice a day for 4 hours was more effective than HBO once a day for 2 hours in bactericidal effect. 4. In treatment on experimental osteomyelitis caused by Bacteroides melaninogenicus, HOB group revealed high recovery rate compared with control group, while there was no significant difference between HBO once a day and HOB twice a day groups statistically. Hyperbaric oxygen therapy was effective in anaerobic osteomyelitis due to B. melaninogenicus by antibacterial activity and improvement of healing process, while it did not appear to be related to antibacterial activity in aerobic osteomyelitis due to S.aureus. Therapeutic effectiveness of hyperbaric oxygen therapy must be considered as an adjunctive treatment of refractory chronic osteomyelitis in respect that it is at least as effective as antibiotic therapy.