Clinical Analysis of the Conservative Treatment for Treating Diabetic Foot Osteomyelitis

Abstract

Category: Diabetes Introduction/Purpose: The question of surgical versus non-surgical treatment for diabetic foot osteomyelitis remains subject to debate. The aims of this study were to analyze the outcome of conservative treatment (antibiotics treatment and conservative surgery) for diabetic foot osteomyelitis and identify the predictive factors of remission in conservative treatment of diabetic foot osteomyelitis. Methods: 77 patients with diabetic foot osteomyelitis who were initially treated by conservative treatment from January 2004 to July 2013 were identified, and their medical records were reviewed. We defined diabetic foot osteomyelitis 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 analyzed. Results: The mean age of the patients was 62.6 years(SD=12.20), and 47(61.0%) of these patients were male. The median diabetes duration was 15.6 years(SD=11.20) and mean HbA1c was 8.7%(SD=2.40). Forty-eight (62.3%) patients healed with conservative treatment (antibiotics treatment and conservative surgery). Twenty-five(32.5%) patients underwentamputation. Inthe multivariate analysis, concomitant peripheral artery diseaseand inadequate antibiotics therapywere associated with failure of conservative treatment. Conclusion: Antibiotics alone, or with conservative surgery, were successful in treating diabetic foot osteomyelitis in 62.3% of the patients. Concomitant peripheral artery diseaseand inadequate antimicrobial therapy were risk factors for remission in diabetic foot osteomyelitis treated conservatively.