Version June 2024
| Anatomic type | |
| Stage 1: Medullary osteomyelitis Medullary osteomyelitis denotes infection confined to the intramedullary surfaces of the bone. Hematogenous osteomyelitis and infected intramedullary rods are examples of this anatomic type. | |
| Stage 2: Superficial osteomyelitis Superficial osteomyelitis is a true contiguous focus infection of bone; it occurs when an exposed infected necrotic surface of bone lies at the base of a soft-tissue wound. | |
| Stage 3: Localized osteomyelitis Localized osteomyelitis is usually characterized by a full thickness, cortical sequestration, which can be removed surgically without compromising bony stability. | |
| Stage 4: Diffuse osteomyelitis Diffuse osteomyelitis is a through-and-through process that usually requires an intercalary resection of the bone to arrest the disease process. Diffuse osteomyelitis includes those infections with a loss of bony stability either before or after debridement surgery. | |
| Physiologic class of host* | |
| Class A denotes a normal host | |
| Class B denotes a host with systemic compromise, local compromise, or both | |
| Class C denotes a host for whom the morbidity of treatment is worse than that imposed by the disease itself | |
| Factors affecting immune surveillance, metabolism, and local vascularity | |
| Systemic factors | Local factors |
| Malnutrition | Chronic lymphedema |
| Renal or hepatic failure | Venous stasis |
| Diabetes mellitus | Major vessel compromise |
| Chronic hypoxia | Arteritis |
| Immune disease | Small vessel disease |
| Malignancy | Extensive scarring |
| Extremes of age | Radiation fibrosis |
| Immunosuppression or immune deficiency | Neuropathy |
| Tobacco abuse (≥2 packs per day) | |
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