Background: Late-stage pressure sore (PS) patients are particularly susceptible to osteomyelitis
(OM), as bony prominences commonly constitute the focal point of the ulcer. There are
lack of data regarding the associated factors and the clinical relevance of this diagnosis in the context
of PS treatment. Methods: This retrospective analysis investigated the clinical characteristics, blood
markers indicative of infection in PS patients, and development of histologically evident OM. A total
of 125 patient were included from 2014 to 2019. The patient records were especially scanned for histological
diagnosis of OM. Results: OM was detected in 39% (37/96) of the samples taken during the
index procedure. OM prevalence increased to 56% (43/77) at the second and 70% (41/59) at the third
debridement. Therefore, the diagnosis of OM was acquired during treatment in 35 cases. Patients
diagnosed with initial OM presented significantly higher blood markers, indicative of infection upon
admission. Only patients with consistent OM (three positive biopsies) showed higher flap revision
rates. Conclusion: This study found no compelling evidence linking OM to worse clinical outcomes
in PS patients. In the absence of elevated inflammatory markers, reducing bone biopsy frequency
and adopting a less aggressive bone debridement approach may help prevent OM in PS patients.