{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T21:05:07Z","timestamp":1789506307306,"version":"build-2803163510"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"\n \n \n \u00bb Stage-4 pressure ulcers are defined as ulcerations that violate the fascia and expose underlying bone, muscle, and tendon.<\/jats:p>\n <\/jats:list-item>\n \n \u00bb Exposed bone is always colonized by bacteria, but this does not necessarily lead to osteomyelitis.<\/jats:p>\n <\/jats:list-item>\n \n \u00bb The rates of osteomyelitis in exposed bone in stage-4 pressure ulcers range from 14% to 86%.<\/jats:p>\n <\/jats:list-item>\n \n \u00bb There has been no evidence that the presence of osteomyelitis leads to higher complication rates following flap coverage.<\/jats:p>\n <\/jats:list-item>\n \n \u00bb There has been no evidence that bone biopsy and preoperative treatment of osteomyelitis have any benefit before flap coverage.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>","DOI":"10.2106\/jbjs.rvw.19.00187","type":"journal-article","created":{"date-parts":[[2020,6,4]],"date-time":"2020-06-04T10:01:44Z","timestamp":1591264904000},"page":"e0187-e0187","source":"Crossref","is-referenced-by-count":9,"title":["Incidence of Osteomyelitis in Sacral Decubitus Ulcers and Recommendations for Management"],"prefix":"10.2106","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1449-7383","authenticated-orcid":false,"given":"Alexander","family":"Crespo","sequence":"first","affiliation":[{"name":"NYU Langone Orthopedics (A.C., N.M.S., and P.L.), NYU Langone Plastic Surgery Associates (E.C.), and Division of Infectious Diseases and Immunology (V.P.), NYU Langone Health, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9427-6993","authenticated-orcid":false,"given":"Nicole M.","family":"Stevens","sequence":"additional","affiliation":[{"name":"NYU Langone Orthopedics (A.C., N.M.S., and P.L.), NYU Langone Plastic Surgery Associates (E.C.), and Division of Infectious Diseases and Immunology (V.P.), NYU Langone Health, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4380-241X","authenticated-orcid":false,"given":"Ernest","family":"Chiu","sequence":"additional","affiliation":[{"name":"NYU Langone Orthopedics (A.C., N.M.S., and P.L.), NYU Langone Plastic Surgery Associates (E.C.), and Division of Infectious Diseases and Immunology (V.P.), NYU Langone Health, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3249-4415","authenticated-orcid":false,"given":"Vinh","family":"Pham","sequence":"additional","affiliation":[{"name":"NYU Langone Orthopedics (A.C., N.M.S., and P.L.), NYU Langone Plastic Surgery Associates (E.C.), and Division of Infectious Diseases and Immunology (V.P.), NYU Langone Health, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8409-8513","authenticated-orcid":false,"given":"Philipp","family":"Leucht","sequence":"additional","affiliation":[{"name":"NYU Langone Orthopedics (A.C., N.M.S., and P.L.), NYU Langone Plastic Surgery Associates (E.C.), and Division of Infectious Diseases and Immunology (V.P.), NYU Langone Health, New York, NY"},{"name":"Department of Cell Biology, NYU School of Medicine, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,6]]},"reference":[{"issue":"9","key":"r1-20230807","doi-asserted-by":"crossref","first-page":"568","DOI":"10.5435\/00124635-201009000-00008","article-title":"Pressure ulcers in orthopaedics","volume":"18","author":"Remaley","year":"2010","journal-title":"J Am Acad Orthop Surg"},{"issue":"6","key":"r2-20230807","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1097\/WON.0000000000000281","article-title":"Revised National Pressure Ulcer Advisory Panel pressure injury staging system: revised pressure injury staging system","volume":"43","author":"Edsberg","year":"2016","journal-title":"J Wound Ostomy Continence Nurs"},{"issue":"3","key":"r3-20230807","first-page":"42","article-title":"Developing and evaluating outcomes of an evidence-based protocol for the treatment of osteomyelitis in stage IV pressure ulcers: a literature and wound electronic medical record database review","volume":"55","author":"Rennert","year":"2009","journal-title":"Ostomy Wound Manage"},{"issue":"12","key":"r4-20230807","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.5858\/2003-127-1599-AAOEAT","article-title":"Autopsy-based assessment of extent and type of osteomyelitis in advanced-grade sacral decubitus ulcers: a histopathologic study","volume":"127","author":"T\u00fcrk","year":"2003","journal-title":"Arch Pathol Lab Med"},{"issue":"7","key":"r5-20230807","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1001\/archinte.1994.00420070067008","article-title":"Osteomyelitis associated with pressure sores","volume":"154","author":"Darouiche","year":"1994","journal-title":"Arch Intern Med"},{"issue":"4","key":"r6-20230807","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1001\/archinte.1983.00350040073010","article-title":"Osteomyelitis beneath pressure sores","volume":"143","author":"Sugarman","year":"1983","journal-title":"Arch Intern Med"},{"issue":"1","key":"r7-20230807","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1097\/00006534-200207000-00021","article-title":"The value of Jamshidi core needle bone biopsy in predicting postoperative osteomyelitis in grade IV pressure ulcer patients","volume":"110","author":"Han","year":"2002","journal-title":"Plast Reconstr Surg"},{"issue":"2","key":"r8-20230807","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1097\/00006534-198802000-00016","article-title":"The diagnosis of osteomyelitis in patients with pressure sores","volume":"81","author":"Lewis","year":"1988","journal-title":"Plast Reconstr Surg"},{"issue":"3","key":"r9-20230807","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/j.cmi.2015.11.005","article-title":"Diagnosing pelvic osteomyelitis beneath pressure ulcers in spinal cord injured patients: a prospective study","volume":"22","author":"Brunel","year":"2016","journal-title":"Clin Microbiol Infect"},{"key":"r10-20230807","first-page":"42","article-title":"Diagnostic and therapeutic value of surgical biopsy of grade IV sacral pressure ulcer","volume":"18","author":"Walley","year":"2017","journal-title":"Orthop J Harvard Med Sch"},{"issue":"2","key":"r11-20230807","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1097\/PRS.0b013e3181fed66e","article-title":"Is there a simple, definitive, and cost-effective way to diagnose osteomyelitis in the pressure ulcer patient?","volume":"127","author":"Larson","year":"2011","journal-title":"Plast Reconstr Surg"},{"issue":"2","key":"r12-20230807","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1148\/radiology.180.2.2068324","article-title":"Osteomyelitis: characteristics and pitfalls of diagnosis with MR imaging","volume":"180","author":"Erdman","year":"1991","journal-title":"Radiology"},{"issue":"2","key":"r13-20230807","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1148\/radiology.173.2.2798868","article-title":"Chronic complicated osteomyelitis of the lower extremity: evaluation with MR imaging","volume":"173","author":"Mason","year":"1989","journal-title":"Radiology"},{"issue":"5","key":"r14-20230807","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1097\/SAP.0b013e3181fec647","article-title":"Effect of preoperative magnetic resonance imaging diagnosis of osteomyelitis on the surgical management and outcomes of pressure ulcers","volume":"67","author":"Daniali","year":"2011","journal-title":"Ann Plast Surg"},{"issue":"4","key":"r15-20230807","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1097\/PRS.0b013e3182442197","article-title":"Protocol management of late-stage pressure ulcers: a 5-year retrospective study of 101 consecutive patients with 179 ulcers","volume":"129","author":"Larson","year":"2012","journal-title":"Plast Reconstr Surg"},{"issue":"4","key":"r16-20230807","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1097\/SAP.0b013e318162f257","article-title":"Successful truncated osteomyelitis treatment for chronic osteomyelitis secondary to pressure ulcers in spinal cord injury patients","volume":"61","author":"Marriott","year":"2008","journal-title":"Ann Plast Surg"},{"issue":"2","key":"r17-20230807","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1093\/cid\/ciy559","article-title":"Osteomyelitis complicating sacral pressure ulcers: whether or not to treat with antibiotic therapy","volume":"68","author":"Wong","year":"2019","journal-title":"Clin Infect Dis"},{"issue":"3","key":"r18-20230807","doi-asserted-by":"crossref","first-page":"ofv112","DOI":"10.1093\/ofid\/ofv112","article-title":"Pressure ulcer-related pelvic osteomyelitis: a neglected disease?","volume":"2","author":"Bodavula","year":"2015","journal-title":"Open Forum Infect Dis"},{"issue":"1","key":"r19-20230807","doi-asserted-by":"crossref","first-page":"e1187","DOI":"10.1097\/GOX.0000000000001187","article-title":"Flap reconstruction for pressure ulcers: an outcomes analysis","volume":"5","author":"Bamba","year":"2017","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"6","key":"r20-20230807","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1097\/00000637-199906000-00015","article-title":"Evaluation of results and treatment variables for pressure ulcers in 48 veteran spinal cord-injured patients","volume":"42","author":"Goodman","year":"1999 Jun","journal-title":"Ann Plast Surg"},{"issue":"2","key":"r21-20230807","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1097\/SLA.0000000000001497","article-title":"Factors associated with treatment failure of infected pressure sores","volume":"264","author":"Jugun","year":"2016","journal-title":"Ann Surg"},{"issue":"2","key":"r22-20230807","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1097\/SAP.0000000000001226","article-title":"Long-term outcomes after flap reconstruction in pediatric pressure ulcers","volume":"80","author":"Firriolo","year":"2018","journal-title":"Ann Plast Surg"}],"container-title":["JBJS Reviews"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.RVW.19.00187","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:35:32Z","timestamp":1787751332000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.RVW.19.00187"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6]]},"references-count":22,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.rvw.19.00187","relation":{},"ISSN":["2329-9185"],"issn-type":[{"value":"2329-9185","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6]]}}}