By Emily Delzell
Nearly two thirds of patients with diabetic foot osteomyelitis heal with medical management alone, with patients with metatarsal site infection most likely to require amputation, according to research from the UK.
Investigators from Norfolk and Norwich University Hospitals NHS Foundation Trust retrospectively evaluated 85 patients with diabetic foot osteomyelitis who were treated initially with standard nonsurgical care. Nearly two thirds (63.5%) reached remission, defined as no clinical or radiological signs of osteomyelitis at initial or adjacent sites during the follow-up period of one year after ending antibiotic therapy. The median duration of antibiotic therapy was 10.8 weeks.
Patients with osteomyelitis affecting the metatarsals were significantly more likely to undergo amputation than those with infection at other sites. Those with absent pedal pulses in the affected foot required a longer duration of antibiotics (8.7 versus 15.9 weeks), but weren’t more likely to need amputation. The authors concluded the slower healing in the latter group warrants prolonged conservative medical management before considering amputation.
The International Journal of Lower Extremity Wounds epublished the results on August 27.
Zeun P, Gooday C, Nunney I, Dhatariya K. Predictors of outcomes in diabetic foot osteomyelitis treated initially with conservative (nonsurgical) medical management: a retrospective study. Int J Low Extrem Wounds 2015 Aug 27. [Epub ahead of print]