Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
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Clinical Analysis of the Conservative Treatment for Diabetic Foot Osteomyelitis

당뇨병성 족부 골수염 치료에서 보존적 치료에 대한 임상적 고찰

  • Kim, Yong-Beom (Department of Orthopaedic Surgery, Seoul Hospital, Soonchunhyang University College of Medicine) ;
  • Lee, Eun Jung (Department of Internal Medicine, Seoul Hospital, Soonchunhyang University College of Medicine) ;
  • Cho, Jaeho (Department of Orthopaedic Surgery, Seoul Paik Hospital, Inje University College of Medicine) ;
  • Kwon, Min-Soo (Department of Orthopaedic Surgery, Seoul Paik Hospital, Inje University College of Medicine) ;
  • Kang, Seung-Gu (Department of Orthopaedic Surgery, Seoul Hospital, Soonchunhyang University College of Medicine) ;
  • Chun, Dong-Il (Department of Orthopaedic Surgery, Seoul Hospital, Soonchunhyang University College of Medicine)
  • 김용범 (순천향대학교 의과대학 서울병원 정형외과학교실) ;
  • 이은정 (순천향대학교 의과대학 서울병원 내과학교실) ;
  • 조재호 (인제대학교 의과대학 서울백병원 정형외과학교실) ;
  • 권민수 (인제대학교 의과대학 서울백병원 정형외과학교실) ;
  • 강승구 (순천향대학교 의과대학 서울병원 정형외과학교실) ;
  • 천동일 (순천향대학교 의과대학 서울병원 정형외과학교실)
  • Received : 2014.11.08
  • Accepted : 2015.07.24
  • Published : 2015.09.15
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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 $62.7{\pm}12.2$ years, and 47 patients (61.0%) were male. The median diabetes duration was $15.7{\pm}11.2$ years and mean HbA1c was $8.7%{\pm}2.4%$. 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.

Keywords

References

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