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Osteomyelitis Associated With Pressure Sores-Reply

Rabih O. Darouiche, MD; Glenn C. Landon, MD; Marcella Klima, MD; Daniel M. Musher, MD; Jon Markowski, MD
Arch Intern Med. 1994;154(21):2501. doi:10.1001/archinte.1994.00420210141017.
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It appears to us that DeHart is not convinced that appropriate treatment of osteomyelitis underlying pressure sores improves the outcome of pressure sores, and neither are we. That is why we specifically mentioned in the last paragraph of the "Comment" section that "The number of patients who had osteomyelitis in our study was too low to comment on the outcome of therapy."1 In our mind, the definitive way to demonstrate the impact of treatment of osteomyelitis is to compare the outcome in patients with osteomyelitis who are randomized either to treatment or to no treatment of osteomyelitis. However, we are sure that DeHart shares with us the opinion that such a comparative investigation might be problematic from an ethical point of view. Since we treated (in fact, had to treat) all six patients in this uncontrolled study who were diagnosed with osteomyelitis, our finding that pressure sores healed in


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