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Diabetes Care, Vol 19, Issue 11 1257-1260, Copyright © 1996 by American Diabetes Association

ARTICLES

Treatment of osteomyelitis in the diabetic foot. Contribution of conservative surgery

G Ha Van, H Siney, JP Danan, C Sachon and A Grimaldi
Department of Diabetology and Metabolism, Groupe Hospitalier Pitie-Salpetriere, Paris, France.

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.
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Copyright © 1996 by the American Diabetes Association.