We evaluated the results of aerobic, anaerobic, and fungal cultures of
specimens that had been obtained from multiple sites in thirty patients who
had traumatic osteomyelitis with a sinus track. In each patient, we
obtained specimens of material from the sinus track; specimens of purulent
fluid, of soft tissue, and of bone obtained from curettage; and specimens
from the bed of the involved bone. More than one organism grew on culture
of the specimens from twenty-one of the patients; more than three
organisms, from those of eleven patients; and ten organisms, from those of
two patients. The same organisms grew on culture of the specimens from
every site in only fourteen (47 per cent) of the thirty patients. We
recommend that specimens of material from the sinus track; specimens of
purulent material, of soft tissue, and of bone obtained from curettage; and
specimens from the bed of the involved bone be obtained for culture before
the treatment of chronic osteomyelitis with a draining sinus, so that as
many of the infecting organisms as possible will be identified.