Original ResearchThe Effect of Residual Osteomyelitis at the Resection Margin in Patients with Surgically Treated Diabetic Foot Infection
Section snippets
Study Design and Outcome Measures
This was a single-center (Gundersen Lutheran Medical Center, La Crosse, WI), retrospective cohort investigation of patients with diabetes mellitus and histologically confirmed osteomyelitis of the foot that was treated with antibiotics and surgical resection of infected bone. Surgical and medical treatment decisions were made at the discretion of the treating clinicians. In general, physician providers treated patients in a multidisciplinary fashion from departments including Internal Medicine,
Results
A total of 262 pathology reports from 241 patients were reviewed for inclusion in the study. Twenty-one patients (8.71%) had a second episode of osteomyelitis at a separate site, but only the initial episode of diabetic foot osteomyelitis was included in this study. One hundred thirty patients were excluded from the study, as follows: 108 patients had osteomyelitis in an area other than the foot, 9 patients did not have diabetes mellitus, 9 patients did not have sufficient pathologic
Discussion
Complete surgical excision of infected bone is considered the treatment of choice for osteomyelitis; however, short of amputation, complete excision is sometimes impossible in diabetic foot osteomyelitis. Recent guidelines suggest that antibiotic therapy route and duration in patients with diabetic foot osteomyelitis should be chosen based on the extent of surgical debridement performed and the presence of residual infected bone and tissue (1). Conceptually, this strategy is appealing, and our
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Conflict of Interest: None reported.