Conservative management of diabetic foot osteomyelitis

Foot infection is a well recognized risk factor for major amputation in diabetic patients. The osteomyelitis is one of the most common expression of diabetic foot infection, being present approximately in present in 10%-15% of moderate and in 50% of severe infectious process. An early and accurate diagnosis is required to ensure a targeted treatment and reduce the risk of major amputation. The aim of this review is to report a complete overview about the management of diabetic foot osteomyelitis. Epidemiology, clinical aspects, diagnosis and treatment are widely described according to scientific reccomendations and our experience.

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“…Some Authors have reduced the role of surgery to treat bone infection, mainly in case of chronic osteomyelitis[52-54]. …”

Section: Treatment Of Osteomyelitismentioning

confidence: 99%

“…The rate of infection recurrence is approximately of 30%[31,54]. Recurrence might be related to the incomplete resection of infected bone or to resistant microorganisms persistently remaining in their biofilm[57].…”

Section: Treatment Of Osteomyelitismentioning

confidence: 99%

Osteomyelitis in diabetic foot: A comprehensive overview

Giurato

Meloni

Izzo

et al. 2017

WJD

135

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“…Diabetic foot infections due to MRSA have been associated with poor wound healing and a higher risk of lower extremity amputation. [53][54][55] An antibiotic with activity against MRSA should be considered in patients with severe infection; patients previously colonized or infected with MRSA; patients on dialysis; patients who failed initial antibiotic therapy, particularly fluoroquinolones; patients with chronic infected large ulcer; and patients in communities where the prevalence of MRSA infection exceeds 10% to 15%. 51,53 Moderate to severe DFIs due to MRSA should be treated initially with parenteral vancomycin, linezolid, daptomycin, tigecycline, ceftaroline, or telavancin.…”

Section: Multidisciplinary Approachmentioning

confidence: 99%

Management of Hospitalized Patients with Diabetic Foot Infections

Bader

Alavi

2014

Hospital Practice

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Diabetic foot infections (DFIs), which present with a variety of clinical manifestations, are commonly encountered by clinicians. They are associated with a high morbidity, a high amputation rate, a high mortality, and increased health care costs. An effective management of DFIs requires a multidisciplinary approach with a strong collaboration among all involved health care providers as well as patient involvement. Diagnosing DFIs appropriately requires consideration of the clinical symptoms and signs of infection in addition to supplementary laboratory testing such as inflammatory markers and imaging studies. The comprehensive patient assessment should include the predisposing risk factors for infection; the type, severity, and extent of the infection; and the assessment of neurologic and vascular status, comorbid conditions, and psychosocial factors. The comprehensive management of DFIs include not only effective antibiotic therapy but also surgical debridement, pressure offloading, wound care and moisture, maintaining good vascular perfusion, control of edema and pain, correction of metabolic abnormalities such as hyperglycemia, and addressing psychosocial and nutritional issues. Discharge planning that addresses full medical and social needs along with suitable follow-up, patient education and counseling, and clear communication with outpatient providers are critical for ensuring a safe and successful transition to outpatient management of hospitalized patients with DFIs.

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“…Recurrence of ulceration/infection is common during or after successful treatment as high as 30% (6, 10, 31), although about two thirds of these recurrences may also be successfully controlled conservatively rather than surgically (6, 31). One randomized study (51) of 52 patients has compared antibiotic and surgical treatment.…”

Section: Conservative Treatment (Antibiotics-only) Vs Operative Manamentioning

confidence: 99%

Osteomyelitis in the diabetic foot

Malhotra¹,

Chan²,

Nather

2014

Diabetic Foot & Ankle

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Osteomyelitis (OM) is a common complication of diabetic foot ulcers and/or diabetic foot infections. This review article discusses the clinical presentation, diagnosis, and treatment of OM in the diabetic foot. Clinical features that point to the possibility of OM include the presence of exposed bone in the depth of a diabetic foot ulcer. Medical imaging studies include plain radiographs, magnetic resonance imaging, and bone scintigraphy. A high index of suspicion is also required to make the diagnosis of OM in the diabetic foot combined with clinical and radiological studies.

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Conservative management of diabetic foot osteomyelitis

Cited by 66 publications

References 23 publications

Osteomyelitis in diabetic foot: A comprehensive overview

Osteomyelitis in diabetic foot: A comprehensive overview

Management of Hospitalized Patients with Diabetic Foot Infections

Osteomyelitis in the diabetic foot

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