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Revista Médica del Uruguay
versión impresa ISSN 0303-3295versión On-line ISSN 1688-0390
Resumen
ORELLANO, Pablo et al. Diabetic foot osteomyelitis. Medical treatment and conservative surgical approach in a Diabetic Foot Unit. Rev. Méd. Urug. [online]. 2022, vol.38, n.1, e301. Epub 01-Mar-2022. ISSN 0303-3295. https://doi.org/10.29193/rmu.38.1.9.
Infection is the most frequent complication in diabetic foot ulcers, and it is the main cause of minor and major lower extremities amputations.
Osteomyelitis accounts for 60% of cases and it constitutes a challenge when it comes to treatment, since controversies arise depending on its clinical presentation.
Resection of the infected bone has been the golden standard, despite it may cause functional sequelae and recurring ulcers. In the last two decades antibiotic therapy has emerged, combined with a conservative surgical approach or no surgery in forefoot lesions, the results being satisfactory.
Objective:
to present the results of medical treatment of foot osteomyelitis in diabetic patients, prioritizing minimal resections that avoid amputations which alter the biomechanics of the foot.
The study evaluated 6 diabetic patients assisted at the Diabetic Foot Unit, with phalanx, metatarsal and calcaneal osteomyelitis. They received antibiotic therapy for 7 ± 2 weeks and resections were limited to the forefoot, showing good evolution. During a one-year follow-up, there were no signs of infection in the initial site or adjacent to the lesion, support of the foot being preserved.
Conclusion:
minimum resection surgery with no local or major amputation is a successful therapy in selected cases of diabetic foot osteomyelitis. Prospective trials are necessary to determine benefits of this management when compared to other approaches.
Palabras clave : Osteomyelitis; Diabetic foot; Conservative surgery; Conservative treatment..
