Cavitary Defect Associated with Osteosynthesis Material: Star Concept in the Management of Chronic Osteomyelitis

In the management of chronic osteomyelitis, there are multiple strategies and tactics to be used in the operating room, recommendations, and instructions by experts. Much emphasis has been placed on the quality of debridement, as far as it is done, the importance of adequate antibiotic therapy and bone stability is expressed. In this chapter, we want to highlight and give importance to multidisciplinary management, the surgeon who is an expert in reconstructive surgery, and a meticulous surgical technique as the most important and fundamental factor in the result and outcome of a severe and chronic bone infection. Hence, the concept STAR (Surgeon Techniques Applied to Reconstruction – Surgical Tactic Applied to Reconstruction), where the training and management of the surgeon are key to the success of limb salvage and reconstructive surgery management in Orthopedics, insisting that this type of procedures should always be performed by an expert and experienced group in bone reconstruction. It matters the material used, the use of new technologies such as bone substitutes with antibiotics or Bioglass at the site of infection, but the most important thing is the detailed technique, a step-by-step tactic to obtain a good result, the formal education and the preparation for surgery. They must be much more rigorously demanded from the specialist to avoid the failures that we see every day, more frequent in handling and approaching such complex cases. Health management companies and colleagues must understand the importance of expert group management of bone infections and encourage formal training to achieve successful results and not forget that the patient only has one chance to improve their health at the time of submitting to a bone infection surgery, it must be by a STAR team.