Diabetes Care · 1996 · 169 citations · 0 references
MedicineOrthopaedic SurgerySurgeryDiabetologyOrthopedicsWound HealingDiabetic Foot DiseaseDiabetic Foot Ulcer CareDiabetic Foot UlcerationFoot OsteomyelitisOsteomyelitisOsteomyelitis ManagementDiabetic Foot Osteomyelitis Antibiotic TherapyDiabetic Foot Ulcer SurgeryFoot Ulcer HealingInfected Foot Ulcer ManagementInfected Foot UlcersOsteomyelitis In Foot UlcersWound Healing MeasurementWound Healing Rate Assessment
The study compared healing duration of diabetic foot ulcers with osteomyelitis treated with medical therapy alone versus medical therapy plus conservative orthopedic surgery. Sixty‑seven diabetic patients with osteomyelitis and no ischemia were divided into a historic group (1986‑1993) receiving antibiotics, offloading, and wound care, and a later group (1993‑1995) receiving the same medical treatment plus conservative orthopedic surgery. The surgical group achieved a higher healing rate (78% vs 57%) and a markedly shorter healing time (181 ± 30 days vs 462 ± 98 days), indicating that conservative surgery improves outcomes for foot ulcers with osteomyelitis.
OBJECTIVE To compare the duration of healing of foot ulcers with osteomyelitis in diabetic patients treated by medical treatment versus medical treatment associated with conservative orthopedic surgery. RESEARCH DESIGN AND METHODS We entered into the study 67 diabetic patients who had a foot ulcer with osteomyelitis without ischemia requiring a peripheral arterial reconstruction. Thirty-two diabetic patients were included in a first historic group from 1986 to 1993, treated by antibiotic therapy, offloading, and wound care. Thirty-two patients were included from September 1993 to March 1995, treated by the same medical treatment and conservative orthopedic surgery. RESULTS The healing rate was 57% in the group treated by the medical treatment alone versus 78% in the surgical group (P < 0.008). The duration of healing was 462 ± 98 days versus 181 ± 30 days (P < 0.008). CONCLUSIONS Conservative surgery contributes to an increase in the healing rate of foot ulcers with osteomyelitis compared with a medical treatment alone.