Hyperthermal effect of laser osteoperforation in a treatment of experimental acute purulent osteomyelitis

We suggest to use laser osteoperforation as a new approach to surgical treatment of acute haemotogenic osteomyelitis. In the present work this approach is studied in experiment on 30 rabbits with an emphasis on a role of hypertermia. The osteomyelitis was produced with the help of an original technique by percutaneous introduction of microorganisms `Staph. Aureus' in medullar channel. The animals were divided into 2 group, experimental (17 rabbits) and control (13). On the 7th day of the illness all animals were subjected to the osteoperforation, with Nd:YAG laser (1064 nm) in the first group and with mechanic drill in the second. During the laser osteoperforation the dynamic control of temperature was performed simultaneously in 5 - 7 points in medullar channel. The original measuring- computational system designed for temperature measurements in the presence of intense laser radiation was used. Significant increase of temperature in medulla was fixed near laser channels, in the range up to 2 mm. In the experimental group the perforation results rapid positive clinical changes and convalescence of all animals confirmed by clinical, roentgenological, and histological tests. In the control group there was no positive dynamics, there were intermuscular phlegmon and plo-inflammatory changes in medulla, sequestra were formed. The reason of such an advantage of laser perforation consists in new factors of action in addition to decompression of medullar channel (available in both methods). The laser produces hypertermia of the medulla which kills a significant part of microorganisms, and it creates intensive radiation field which, possible, stimulates reparative processes.