Faculty of 1000 evaluation for Antibiotics versus conservative surgery for treating diabetic foot osteomyelitis. A randomized comparative trial.

2013 ◽  
Author(s):  
Toshio Matsumoto ◽  
Seiji Fukumoto
Keyword(s):  
Diabetic Foot ◽  
Comparative Trial ◽  
Conservative Surgery ◽  
Diabetic Foot Osteomyelitis

scholarly journals Antibiotics Versus Conservative Surgery for Treating Diabetic Foot Osteomyelitis: A Randomized Comparative Trial

Diabetes Care ◽  
2013 ◽  
Vol 37 (3) ◽  
pp. 789-795 ◽  
Author(s):  
José Luis Lázaro-Martínez ◽  
Javier Aragón-Sánchez ◽  
Esther García-Morales
Keyword(s):  
Diabetic Foot ◽  
Comparative Trial ◽  
Conservative Surgery ◽  
Diabetic Foot Osteomyelitis

Controversial Issues Regarding Positive Bone Margins in Surgery for Diabetic Foot Osteomyelitis: A Pilot Study

2021 ◽  
pp. 153473462110412
Author(s):  
Javier Aragón-Sánchez ◽  
Gerardo Víquez-Molina ◽  
María Eugenia López-Valverde
Keyword(s):  
Pilot Study ◽  
Diabetic Foot ◽  
Soft Tissues ◽  
Conservative Surgery ◽  
Histopathological Analysis ◽  
Positive Margins ◽  
Short Period ◽  
Median Period ◽  
A Minor ◽  
Diabetic Foot Osteomyelitis

Obtaining clean margins in patients who undergo surgical treatment for diabetic foot osteomyelitis (DFO) is recommended. We hypothesize that the rate of recurrence of the infection is not associated with positive margins, even when using a short-term duration of postoperative antibiotic treatment. We conducted a retrospective pilot study of patients who underwent surgery for DFO confirmed by histopathological analysis of the resected bone from August 1, 2020, to December 1, 2020. Bone samples were taken from the proximal margins to be studied by microbiology and histopathology. Twenty-five (89.3%) patients underwent conservative surgery, and 3 (10.7%) patients underwent a minor amputation. After surgery, the antibiotics were stopped in 19 (67.9%) patients and continued in 9 (32.1%) patients for a median period of 4 days. The microbiology of the bone margins was positive in 20 (71.4%) cases, but the histopathology of the bone margins was positive in just 7 (25%) cases. Recurrence of the infection was detected in 3 (10.7%) patients. Seventeen (68%) patients with microbiological-positive margins did not have a recurrence of infection, while 3 (100%) patients had a recurrence of infection ( P = .53). Six (24%) patients among those with histopathological-positive margins did not have a recurrence of infection, and1 (33.3%) patient had a recurrence of infection ( P = 1). The recurrence of infection was low and always detected in soft tissues, including the cases with a histopathological-positive bone margin. Postoperative antibiotics were administered for a short period of time and not based on the analysis of bone margins.

Conservative Surgery for Diabetic Foot Osteomyelitis is not Associated With Longer Survival Time Without Recurrence of Foot Ulcer When Compared With Amputation

2021 ◽  
pp. 153473462110094
Author(s):  
Javier Aragón-Sánchez ◽  
Gerardo Víquez-Molina ◽  
María E. López-Valverde ◽  
José M. Rojas-Bonilla ◽  
Christian Murillo-Vargas
Keyword(s):  
Survival Time ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Conservative Surgery ◽  
Bone Infection ◽  
Survival Times ◽  
Cumulative Survival ◽  
Kaplan Meier ◽  
Patients With Diabetes ◽  
Diabetic Foot Osteomyelitis

Conservative surgery of diabetic foot osteomyelitis (DFO) in which bone infection is removed without amputation could minimize the biomechanical changes associated with foot surgery. We hypothesize that patients who undergo conservative surgery will have a longer survival time without recurrence of foot ulcers and further amputations than those who undergo any type of amputation to treat DFO. We assessed a retrospective cohort of 108 patients who underwent surgery for DFO from January 2011 to December 2012. Patients were followed-up until May 2020. Reulceration and reamputation-free survival times were plotted using the Kaplan–Meier method and were calculated from the date of first surgery to recurrence, new amputation, or end of the study. A stratified log rank was used to study differences among groups. Cumulative survival without recurrences at 1, 5, and 8 years was 95%, 36%, and 29%, respectively, in patients who underwent conservative surgery and 95%, 43%, and 30%, respectively, in those undergoing amputation. Cumulative survival without a new amputation at 1, 5, and 8 years was 100%, 80%, and 80%, respectively, in patients who underwent conservative surgery and 98%, 82%, and 69%, respectively, in those undergoing amputation. No differences were found regarding either recurrence (log rank, P = .98) or new amputations (log rank, P = .64). In conclusion, conservative surgery is as safe as amputation to arrest bone infection in the feet of patients with diabetes. Conservative surgery was not associated with a lower rate of recurrence and new amputations than those patients who underwent amputations.

scholarly journals Conservative surgery for chronic diabetic foot osteomyelitis: Procedures and recommendations

2020 ◽  
Author(s):  
José Luis Lázaro-Martínez ◽  
Marta García-Madrid ◽  
Yolanda García-Alvarez ◽  
Francisco Javier Álvaro-Afonso ◽  
Irene Sanz-Corbalán ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Conservative Surgery ◽  
Diabetic Foot Osteomyelitis
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