Risk factors for developing osteomyelitis in patients with diabetic foot wounds

Lavery, Lawrence A.; Peters, Edgar J.G.; Armstrong, David G.; Wendel, Christopher; Murdoch, Douglas P.; Lipsky, Benjamin A.

doi:10.1016/j.diabres.2008.11.030

Cited by 132 publications

(84 citation statements)

References 35 publications

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“…Nevertheless, our findings overall complement those identified in a systematic review and meta-analysis of diabetic foot infections which suggests that factors increasing the likelihood of osteomyelitis are probing to bone, ulcer size >2 cm 2 , ulcer duration >2 weeks or erythrocyte sedimentation rate >70. [5][6][7][8] Some case series suggest that a negative probe to bone test has a strong negative predictive value (0.98), whereas a positive probe to bone test only has a positive predictive value of 0.57. 9 In our series, however, the inability to probe to bone did not reliably exclude osteomyelitis, consistent with many studies that suggest no single factor can reliably include/ exclude osteomyelitis.…”

Section: Discussionmentioning

confidence: 99%

“…9 In our series, however, the inability to probe to bone did not reliably exclude osteomyelitis, consistent with many studies that suggest no single factor can reliably include/ exclude osteomyelitis. [5][6][7] A limitation of this small case series review is that bone biopsy was not performed for microbiological identification. Other studies of diabetic foot infection have found that bone biopsy guided antibiotic treatment may be more effective.…”

Section: Discussionmentioning

confidence: 99%

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Characteristics of calcaneal osteomyelitis: an unusual and severe form of diabetic foot disease

et al. 2015

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Background: Osteomyelitis of the calcaneus is an uncommon type of diabetic foot infection considered to have a poor outcome. Little is known about predisposing and prognostic factors, or optimum treatment regimens. Conclusions: In patients with diabetes and heel ulcers, calcaneal osteomyelitis is associated with male gender, neuropathy and large deep ulcers. It is uncommon and has a poor prognosis. We were unable to identify any factors associated with improved prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Characteristics of calcaneal osteomyelitis: an unusual and severe form of diabetic foot disease

et al. 2015

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“…There may be an obvious large wound or ulcer associated with erythema and pyrexia. The presence of any exposed bone and ulcer larger than 2 cm 2 increasesthe likelihood of osteomyelitis [17]. Osteomyelitis should be suspected in a patient with an adequate blood supply to the affected foot that has a deep ulcer which would not heal after 6 weeks of appropriate wound care and off-loading [17].…”

Section: Clinical Features and Diagnosismentioning

confidence: 99%

“…The presence of any exposed bone and ulcer larger than 2 cm 2 increasesthe likelihood of osteomyelitis [17]. Osteomyelitis should be suspected in a patient with an adequate blood supply to the affected foot that has a deep ulcer which would not heal after 6 weeks of appropriate wound care and off-loading [17]. It is important to distinguish between the ischaemic and the neuropathic foot although these factors may co-exist [2,6].…”

Section: Clinical Features and Diagnosismentioning

confidence: 99%

The Diabetic Foot

Weledji¹

2015

J Nurs Care

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Diabetic foot infections are a frequent clinical problem. About 50% of diabetic foot infections who have foot amputations die within five years. Properly managed most can be cured, but many patients needlessly undergo amputations because of improper diagnostic and therapeutic approaches. This approach along with vascular assessment help clinical decisions about which patients to hospitalize, which to send for imaging procedures or for whom to recommend surgical interventions. This paper reviewed the natural history of the diabetic foot and assessed the surgical impact of the Infectious Diseases Society of America clinical practice guideline-based care of diabetic foot infections. Keywords: Diabetic foot infection; Neuropathic foot; Ischaemic foot; Risk factors; Medical and surgical management; Prevention MethodsElectronic searches of the medline (PubMed) database, Cochrane library, and science citation index were performed to identify original published studies on the natural history and current management of the diabetic foot. Relevant articles were searched from relevant chapters in specialized texts and all were included.

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“…1 A DFU carries a 50% risk for infection and at least 20% of those receive some form of amputation. [2][3][4] Foot ulcers manifest themselves as a region of tissue loss typically below the malleoli. Treatment of a DFU is essential to reduce the risk of complications and amputations.…”

Section: Symposiummentioning

confidence: 99%

Real-Time Smart Textile-Based System to Monitor Pressure Offloading of Diabetic Foot Ulcers

Raviglione

Reif²,

Macagno³

et al. 2017

J Diabetes Sci Technol

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Background: The lifetime risk of developing a diabetic foot ulcer (DFU) is at least 25%. A DFU carries a 50% risk for infection and at least 20% of those receive some form of amputation. The most significant parameter that prevents or delays ulcer healing is high plantar pressure. To improve the patient's healing process, the DFU's plantar pressure should remain cumulatively low. Therefore, a tool that continuously measures the DFU loading, and provides real-time feedback can improve the healing outcome. Methods:We report the development of a system capable of continuously measuring the pressure, which could have applications to monitor DFU. The system contains a textile pressure sensor attached to a stretchable band, hardware that collects data and transmits them via Bluetooth to a phone, an app that gathers the data and stores them in the cloud, and a web dashboard that displays the data to the clinician. The sensor was characterized in vitro using the system, and the webdashboard was developed and tested on simulated patient data. Results:We demonstrate the feasibility of developing the system and characterize the pressure response of the device. As a result, we demonstrate a viable method for monitoring DFU off-loading in real time. Conclusions:The presented study demonstrates the feasibility to develop a simple, modular wearable system that opens up new possibilities for diabetic foot ulcer care by providing a way of monitoring the pressure under the ulcer in real time.

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Risk factors for developing osteomyelitis in patients with diabetic foot wounds

Cited by 132 publications

References 35 publications

Characteristics of calcaneal osteomyelitis: an unusual and severe form of diabetic foot disease

Characteristics of calcaneal osteomyelitis: an unusual and severe form of diabetic foot disease

The Diabetic Foot

Real-Time Smart Textile-Based System to Monitor Pressure Offloading of Diabetic Foot Ulcers

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