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Lesens O, Desbiez F, Theïs C, Ferry T, Bensalem M, Laurichesse H, Tauveron I, Beytout J, Aragón Sánchez J, Working Group on Diabetic Osteomyelitis., et al.
The international journal of lower extremity wounds. Date of publication 2015 Sep 1;volume 14(3):284-90.
1. Int J Low Extrem Wounds. 2015 Sep;14(3):284-90. doi: 10.1177/1534734614559931. Epub 2014 Dec 16. Staphylococcus aureus-Related Diabetic Osteomyelitis: Medical or Surgical Management? A French and Spanish Retrospective Cohort. Lesens O(1), Desbiez F(2), Theïs C(3), Ferry T(4), Bensalem M(5), Laurichesse H(3), Tauveron I(6), Beytout J(3), Aragón Sánchez J(7); Working Group on Diabetic Osteomyelitis. Author information: (1)Service des maladies infectieuses et tropicales Hôpital Gabriel Montpied, Clermont-Ferrand, France olesens@chu-clermontferrand.fr. (2)Service d'endocrinologie Hôpital Gabriel Montpied, Clermont-Ferrand, France. (3)Service des maladies infectieuses et tropicales Hôpital Gabriel Montpied, Clermont-Ferrand, France. (4)University of Lyon Claude Bernard, Lyon, France Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France. (5)Centre hospitalier d'Annecy, Metz-Tessy, France. (6)University of Lyon Claude Bernard, Lyon, France. (7)La Paloma Hospital, Las Palmas de Gran Canaria, Spain. Staphylococcus aureus is the main cause of diabetic foot osteomyelitis (DFO) and can be treated medically or by surgery. We investigated the outcome of consecutive patients with a diagnosis of S aureus DFO retrospectively in 4 hospitals according to the type of management, medical (including debridement at bedside) or surgical. The outcome was classified as either favorable or failure (relapse, impaired wound healing, or amputation). Seventy-four patients with S aureus DFO, including 26 with methicillin-resistant S aureus, were included with a mean duration of follow-up of 21 ± 1 months. As part of the initial treatment, 47% underwent bone surgery followed with a short course of antibiotic. Others were treated with antibiotic therapy alone with bedside debridement. The outcome was favorable for 84% of these patients, with similar rates in the surgical and medical groups (80% vs 87%, P > .05). Patients in the medical group were less frequently hospitalized (49% vs 94%, P < .001) and had a shorter length of hospital stay (17 ± 3 vs 50 ± 12 days, P = .004). Patients in the surgery group received a shorter course of antibiotic therapy (10 ± 2 vs 11 ± 1 weeks, P = .001) with fewer side effects (9% vs 33%, P = .01). The type of management was not associated with subsequent new episode of noncontiguous DFO, which developed in 32% of cases. In conclusion, except significant differences in duration of hospitalization and antibiotic therapy, medical and surgical management of S aureus DFO had similar outcomes with a cure rate >80%. © The Author(s) 2014. DOI: 10.1177/1534734614559931 PMID: 25515373 [Indexed for MEDLINE]
Appears in following Topics:
Diabetic Foot Ulcer - Treatment
Diabetic Foot Ulcer Associated with Infection - Management