Conservative surgical treatment for ...
Type de document :
Article dans une revue scientifique: Article original
DOI :
PMID :
URL permanente :
Titre :
Conservative surgical treatment for metatarsal osteomyelitis in diabetic foot experience of two French centres.
Auteur(s) :
Nguyen, Sophie [Auteur]
GHT de l'Artois
Wallard, Pauline [Auteur]
GHT de l'Artois
Robineau, Olivier [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Centre Hospitalier Gustave Dron [Tourcoing]
Topolinski, Hélène [Auteur]
GHT de l'Artois
Beltrand, Eric [Auteur]
Centre Hospitalier Gustave Dron [Tourcoing]
Benkanoun, Ali [Auteur]
GHT de l'Artois
Baranski, Didier [Auteur]
GHT de l'Artois
Descamps, Dominique [Auteur]
GHT de l'Artois
Senneville, Eric [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Centre Hospitalier Gustave Dron [Tourcoing]
GHT de l'Artois
Wallard, Pauline [Auteur]
GHT de l'Artois
Robineau, Olivier [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Centre Hospitalier Gustave Dron [Tourcoing]
Topolinski, Hélène [Auteur]
GHT de l'Artois
Beltrand, Eric [Auteur]
Centre Hospitalier Gustave Dron [Tourcoing]
Benkanoun, Ali [Auteur]
GHT de l'Artois
Baranski, Didier [Auteur]
GHT de l'Artois
Descamps, Dominique [Auteur]
GHT de l'Artois
Senneville, Eric [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Centre Hospitalier Gustave Dron [Tourcoing]
Titre de la revue :
Diabetes/Metabolism Research and Reviews
Nom court de la revue :
Diabetes Metab Res Rev
Pagination :
e3534
Date de publication :
2022-05-05
ISSN :
1520-7560
Mot(s)-clé(s) en anglais :
conservative surgery
diabetic foot
osteomyelitis
diabetic foot
osteomyelitis
Discipline(s) HAL :
Sciences du Vivant [q-bio]
Résumé en anglais : [en]
Aims
Conservative surgery (CS) for diabetic foot osteomyelitis (DFO) consists in removing all or part of the infected bone tissues without amputation, in complement with antibiotic therapy. Data on CS for DFO therapy ...
Lire la suite >Aims Conservative surgery (CS) for diabetic foot osteomyelitis (DFO) consists in removing all or part of the infected bone tissues without amputation, in complement with antibiotic therapy. Data on CS for DFO therapy are scarce. Material and Methods We performed a retrospective analysis of all DFO episodes treated with CS between 06/2007 and 12/2017. Remission was defined by the absence of soft-tissue infection, complete sustained (i.e. > 1 month) healing of the foot ulcer, favourable (i.e., stabilisation or improvement) radiological outcome, and no need for additional surgery during a 1-year follow-up. Results During the study period, 47 episodes (in 41 patients) were analysed. Excluding deaths (all unrelated to the DFO; n = 3) or loss to follow-up before 1 year (n = 5), the remission rate was 64.2%. Most failures occurred during the first 6 months (79%, 11/14). Patients who experienced failure had a higher rate of peripheral arterial disease with arterial stenosis than patients in remission (57% vs. 24%, P = 0.03), a higher C-reactive protein rate at admission (116 ± 112 mg/L vs. 48 ± 46 mg/L, P = 0.02), and a trend for a higher rate of abscesses (29% vs. 4%, P = 0.06). At 1-year follow-up, foot ulcers related to transfer lesion were identified in 25.5% of the cases. At the last follow-up (mean 3 ± 2 years), the remission rate was 23/25 (92%). Conclusions Our results suggest that CS is a therapeutic option in patients with localised but severe DFO. Clinicians should, however, consider the necessity of revascularisation, and higher risk of failure if surgery is performed in patients presenting with acute foot infections.Lire moins >
Lire la suite >Aims Conservative surgery (CS) for diabetic foot osteomyelitis (DFO) consists in removing all or part of the infected bone tissues without amputation, in complement with antibiotic therapy. Data on CS for DFO therapy are scarce. Material and Methods We performed a retrospective analysis of all DFO episodes treated with CS between 06/2007 and 12/2017. Remission was defined by the absence of soft-tissue infection, complete sustained (i.e. > 1 month) healing of the foot ulcer, favourable (i.e., stabilisation or improvement) radiological outcome, and no need for additional surgery during a 1-year follow-up. Results During the study period, 47 episodes (in 41 patients) were analysed. Excluding deaths (all unrelated to the DFO; n = 3) or loss to follow-up before 1 year (n = 5), the remission rate was 64.2%. Most failures occurred during the first 6 months (79%, 11/14). Patients who experienced failure had a higher rate of peripheral arterial disease with arterial stenosis than patients in remission (57% vs. 24%, P = 0.03), a higher C-reactive protein rate at admission (116 ± 112 mg/L vs. 48 ± 46 mg/L, P = 0.02), and a trend for a higher rate of abscesses (29% vs. 4%, P = 0.06). At 1-year follow-up, foot ulcers related to transfer lesion were identified in 25.5% of the cases. At the last follow-up (mean 3 ± 2 years), the remission rate was 23/25 (92%). Conclusions Our results suggest that CS is a therapeutic option in patients with localised but severe DFO. Clinicians should, however, consider the necessity of revascularisation, and higher risk of failure if surgery is performed in patients presenting with acute foot infections.Lire moins >
Langue :
Anglais
Audience :
Internationale
Vulgarisation :
Non
Établissement(s) :
Université de Lille
CHU Lille
CHU Lille
Date de dépôt :
2023-11-15T04:15:04Z
2024-01-16T08:22:48Z
2024-01-16T08:22:48Z