Please use this identifier to cite or link to this item:
http://hdl.handle.net/10553/48709
Title: | Outcomes of surgical treatment of diabetic foot osteomyelitis: A series of 185 patients with histopathological confirmation of bone involvement | Authors: | Aragon Sanchez, Javier Cabrera-Galván, J. J. Quintana-Marrero, Y. Hernández-Herrero, M. J. Lázaro-Martínez, J. L. García-Morales, E. Beneit-Montesinos, J. V. Armstrong, D. G. |
UNESCO Clasification: | 32 Ciencias médicas 320502 Endocrinología |
Keywords: | Bone infection Diabetic foot Diabetic foot infections Foot ulcer Necrotising, et al |
Issue Date: | 2008 | Journal: | Diabetologia (Berlin) | Abstract: | Aims/hypothesis: We analysed the factors that determine the outcomes of surgical treatment of osteomyelitis of the foot in diabetic patients given early surgical treatment within 12 h of admission and treated with prioritisation of foot-sparing surgery and avoidance of amputation. Methods: A consecutive series of 185 diabetic patients with foot osteomyelitis and histopathological confirmation of bone involvement were followed until healing, amputation or death. Results: Probing to bone was positive in 175 cases (94.5%) and radiological signs of osteomyelitis were found in 157 cases (84.8%). Staphylococcus aureus was the organism isolated in the majority of cultures (51.3%), and in 35 cases (36.8%) it proved to be methicillin-resistant. The surgical treatment performed included 91 conservative surgical procedures, which were defined as those where no amputation of any part of the foot was undertaken (49.1%). A total of 94 patients received some degree of amputation, consisting of 79 foot-level (minor) amputations (42.4%) and 15 major amputations (8%). Five patients died during the perioperative period (2.7%). Histopathological analysis revealed 94 cases (50.8%) of acute osteomyelitis, 43 cases (23.2%) of chronic osteomyelitis, 45 cases (24.3%) of acute exacerbation of chronic osteomyelitis and three remaining cases (1.6%) designated as 'other'. The risks of failure in the case of conservative surgery were exposed bone, the presence of ischaemia and necrotising soft tissue infection. Conclusions/interpretation: Conservative surgery without local or high-level amputation is successful in almost half of the cases of diabetic foot osteomyelitis. Prospective trials should be undertaken to determine the relative roles of conservative surgery versus other approaches. | URI: | http://hdl.handle.net/10553/48709 | ISSN: | 0012-186X | DOI: | 10.1007/s00125-008-1131-8 | Source: | Diabetologia[ISSN 0012-186X],v. 51, p. 1962-1970 (Noviembre 2008) |
Appears in Collections: | Artículos |
Items in accedaCRIS are protected by copyright, with all rights reserved, unless otherwise indicated.