Title :

Reliability and Safety of Bedside Blind Bone Biopsy Performed by a Diabetologist for the Diagnosis and Treatment of Diabetic Foot Osteomyelitis

Author(s) :

Féron, F. [Auteur]
De Ponfilly, G. P. [Auteur]
Potier, L. [Auteur]
Gauthier, D. C. [Auteur]
Salle, L. [Auteur]
Laloi-Michelin, M. [Auteur]
Munier, A. L. [Auteur]
Jacquier, H. [Auteur]
Vidal-Trécan, T. [Auteur]
Julla, J. B. [Auteur]
Université Paris-Sorbonne [UP4]
Carlier, A. [Auteur]
Abouleka, Y. [Auteur]
Venteclef, N. [Auteur]
Grall, N. [Auteur]
Mercier, F. [Auteur]
Riveline, J. P. [Auteur]
Senneville, Eric [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Gautier, J. F. [Auteur]
Université Paris-Sorbonne [UP4]
Roussel, R. [Auteur]
Université Paris-Sorbonne [UP4]
Kevorkian, J. P. [Auteur]

Journal title :

Diabetes Care

Abbreviated title :

Diabetes Care

Volume number :

44

Pages :

p. 2480–2486

Publication date :

2021-11

ISSN :

1935-5548

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

OBJECTIVE Bone biopsy (BB) performed by a surgeon or an interventional radiologist is recommended for suspicion of osteomyelitis underlying diabetic foot ulcer (DFU). To facilitate its practice, we developed a procedure ...
Show more >OBJECTIVE Bone biopsy (BB) performed by a surgeon or an interventional radiologist is recommended for suspicion of osteomyelitis underlying diabetic foot ulcer (DFU). To facilitate its practice, we developed a procedure allowing bedside blind bone biopsy (B4) by a diabetologist. RESEARCH DESIGN AND METHODS We conducted a three-step observational study consisting of a feasibility and safety phase (phase 1) to assess the success and side effects of B4, a validity phase (phase 2) to compare DFU outcomes between positive (B4+) and negative (B4−) bone cultures, and a performance phase (phase 3) to compare B4 with the conventional surgical or radiological procedure basic bone biopsy (B3). Primary end points were the presence of bone tissue (phase 1) and complete DFU healing with exclusive medical treatment at 12 months (phases 2 and 3). RESULTS In phase 1, 37 consecutive patients with clinical and/or radiological suspicion of DFU osteomyelitis underwent B4. Bone tissue was collected in all patients with few side effects. In phase 2, a B4+ bone culture was found in 40 of 79 (50.6%) participants. Among B4+ patients, complete wound healing after treatment was 57.5%. No statistical difference was observed with patients with B4− bone culture not treated with antibiotics (71.8%, P = 0.18). In phase 3, the proportion of patients with positive BB was lower in B4 (40 of 79, 50.6%) than in B3 (34 of 44, 77.3%, P < 0.01). However, complete healing was similar (64.6% vs. 54.6%, P = 0.28). No difference in rate of culture contamination was observed. CONCLUSIONS B4 is a simple, safe, and efficient procedure for the diagnosis of DFU osteomyelitis with a similar proportion of healing to conventional BB.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
CHU Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2023-11-15T05:56:13Z
2024-01-11T10:17:52Z