**1. Introduction**

The Codivilla-Putti Institutes has been a strong will of Prof. Vittorio Putti, especially for treating chronic infections; it started its activity in 1930 and had been located in a famous winter sport resort, as it was the case for almost all sanatoriums build in those years to treat septical diseases with "good air" and sun (UV rays), that were then the only therapeutic treatments available to the medical science.

We are now facing in modern therapeutic treatment of chronic osteomyelitis some growing obstacles in using antibiotics, as we find often resistance, principally concerning staphylococcus, which are the major responsible concerning bone infections. The clinician therefore has to dispose not only of surgical knowledge, but


#### **Table 1.**

*Historical list of work on immunotherapy in osteomyelitis.*

he has to be also acquainted with all most recent advances in the field of antibiotic therapies. Moreover, he has to be acquainted with the immunoresponses offered by the body in special circumstances. As a matter of fact the lack of success in such cases induced many scientists to re-evaluate the immunological system by considering its possible deficit.

An immunodeficiency may also show itself in the clinical picture as an increased tendency to chronicize, a reduced phlogistic reaction and an increased frequency of multifocal processes [1].

The use of the so-called "immunotherapy" started at the beginning of the 20th century and is still a field of investigation (**Table 1**) [1–3].

## **2. Definition of chronic**

Chronic osteomyelitis as all forms of bone inflammatory lesions, sustained by pyogenic germs, who selectively involved from the start bone marrow and intratrabecular spaces and therefore are not healing anyhow, as they brought about a suppuration process, but engender foci in the internal part of bones, who maintain themselves active or more or less weakened [4].

Chronicizing may be:

