Aragón-Sánchez J, Lázaro-Martínez JL, Hernández-Herrero C, Campillo-Vilorio N, Quintana-Marrero Y, García-Morales E, Hernández-Herrero MJ, et al.
Diabetic medicine : a journal of the British Diabetic Association. Date of publication 2012 Jun 1;volume 29(6):813-8.
1. Diabet Med. 2012 Jun;29(6):813-8. doi: 10.1111/j.1464-5491.2011.03528.x.
Does osteomyelitis in the feet of patients with diabetes really recur after
surgical treatment? Natural history of a surgical series.
Aragón-Sánchez J(1), Lázaro-Martínez JL, Hernández-Herrero C, Campillo-Vilorio N,
Quintana-Marrero Y, García-Morales E, Hernández-Herrero MJ.
Author information:
(1)Diabetic Foot Unit, La Paloma Hospital, Las Palmas de Gran Canaria, Seville,
Spain. javiaragon@telefonica.net
AIMS/HYPOTHESIS: The aim of this study was to determine the rate of recurrence,
reulceration and new episodes of osteomyelitis and the duration of postoperative
antibiotic treatment in a prospective cohort of patients with diabetes who
underwent conservative surgery for osteomyelitis.
METHODS: The prospective cohort included patients with diabetes and a definitive
diagnosis of osteomyelitis who were admitted to the Diabetic Foot Unit (Surgery
Department, La Paloma Hospital, Las Palmas de Gran Canaria, Spain) and underwent
surgical treatment from 1 November 2007 to 30 May 2010.
RESULTS: Eighty-one patients were operated on for osteomyelitis during the study
period. Seven patients were lost to follow-up at different stages of the study.
The median duration of follow-up was 101.8 weeks (quartile 1 = 56.6, quartile 3 =
126.7). Forty-eight patients (59.3%) underwent conservative surgery, 32 (39.5%)
had minor amputations and there was one (1.2%) major amputation. Twenty patients
(24.7%) required reoperation because of persistent infection. Postoperative
antibiotic treatment over a median period of 36 days was provided. Wound healing
was achieved by secondary intention for a median of 8 weeks. Sixty-five patients
were available for follow-up after healing. The percentage of recurrence,
reulceration, and new episodes of osteomyelitis was 4.6% (3/65), 43% (28/65) and
16.9% (11/65), respectively. Mortality during follow-up (excluding in-hospital
deaths and patients lost to follow-up) was 13% (9/69).
CONCLUSION: A low rate of recurrence of osteomyelitis after surgical treatment
for osteomyelitis was achieved. Despite new episodes, our approach to managing
this cohort of patients with diabetes and foot osteomyelitis achieved 98.8% limb
salvage.
© 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.
DOI: 10.1111/j.1464-5491.2011.03528.x
PMID: 22151429 [Indexed for MEDLINE]
