J Korean Foot Ankle Soc.  2015 Sep;19(3):107-113. 10.14193/jkfas.2015.19.3.107.

Clinical Analysis of the Conservative Treatment for Diabetic Foot Osteomyelitis

• Kim YB
• Lee EJ
• Cho J
• Kwon MS
• Kang SG
• Chun DI

• KMID: 2045014
• DOI: http://doi.org/10.14193/jkfas.2015.19.3.107

Abstract

PURPOSE
The question of surgical versus non-surgical treatment for diabetic foot osteomyelitis remains subject to debate. The aims of this study were to analyse the outcome of conservative treatment (antibiotic treatment and conservative surgery) for diabetic foot osteomyelitis and identify the predictive factors of remission in conservative treatment of diabetic foot osteomyelitis.
MATERIALS AND METHODS
Seventy-seven patients with diabetic foot osteomyelitis who initially received conservative treatment from January 2004 to July 2013 were identified, and their medical records were reviewed. Diabetic foot osteomyelitis was defined by imaging studies or histological evidence. Remission was defined as the absence of any sign of infection at the initial or contiguous site assessed at least 12 months after the end of treatment. The demographic, clinical, and therapeutic factors were analysed.
RESULTS
The mean age of the patients was 62.7+/-12.2 years, and 47 patients (61.0%) were male. The median diabetes duration was 15.7+/-11.2 years and mean HbA1c was 8.7%+/-2.4%. Forty-eight patients (62.3%) healed with conservative treatment (antibiotic treatment and conservative surgery). Twenty-five patients (32.5%) underwent amputation. In the multivariate analysis, concomitant peripheral artery disease and inadequate antibiotic therapy were associated with failure of conservative treatment.
CONCLUSION
Antibiotics alone, or with conservative surgery, were successful in treatment of diabetic foot osteomyelitis in 62.3% of the patients. Concomitant peripheral artery disease and inadequate antimicrobial therapy were risk factors for remission in conservatively treated diabetic foot osteomyelitis.

Keyword

Diabetic foot; Osteomyelitis; Antibiotics; Surgery; Amputation

MeSH Terms

Amputation
Anti-Bacterial Agents
Diabetic Foot*
Humans
Male
Medical Records
Multivariate Analysis
Osteomyelitis*
Peripheral Arterial Disease
Risk Factors
Anti-Bacterial Agents

Reference

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