Paprika sign during debridement is crucial in management which of the following condition?
Ans. is 'a' i.e., Chronic osteomyelitis Sequestrectomy and curettage for chronic osteomyelitis* Sequestrectomy and curettage require more time toperform and result in considerably more blood loss than aninexperienced surgeon would anticipate. Consequently,appropriate preparation should be made before surgery.Sinus tracks can be injected with methylene blue 24 hoursbefore surgery to make them easier to locate and exciseTechnique:* Expose the infected area of bone, and excise all sinus tracts completely.* Incise the indurated periosteum, and elevate it 1.3 to2.5 cm on each side.* Use a drill to outline an oval cortical window at the appropriate site, and remove it with an osteotome.* Remove all sequestra, purulent material, and scarred and necrotic tissue. If sclerotic bone sealsoff a cavity within the medullary canal, open it into thecanal in both directions to allow blood vessels to growinto the cavity. Use a high-speed burr to debride necrotic or ischemic bone until the "paprika sign" (active punctate bleeding bone) is achieved, indicating healthy tissue.Tissue obtained at surgical debridement should be sentfor culture and pathology studies.* After removing all suspicious matter, carefully excise the overhanging edges of bone. Subsequent dead space can be filled with antibiotic PMMA beads. A soft tissue, a localmuscle flap, or a free tissue transfer can be performed atthe time of bead removal.* If there is nonunion with any bony instability, the bonemust be stabilized, preferably with an Ilizarov-type external frame.* If possible, close the skin loosely over drains and ensurethat no excessive skin tension is present. If closure isimpossible, pack the wound open loosely or apply an antibiotic bead pouch and plan for delayed closure or skingrafting at a later time.* Appropriate antibiotics should be used before, during, and after the operation.
Chronic osteomyelitis
Osteosarcoma
Osteoid osteoma
Brodies abscess
Infection of Bones & Joints