Treatment of osteomielitis in patients with diabetic foot ulcers — retrospective analysis of surgical and conservative treatment outcomes

Abstract

Osteomyelitis is a frequent complication of chronic diabetic foot ulcers which significantly increases the risk of limb amputation. There is controversy as to the best method of treatment for this condition. In our study we compared the outcomes of surgical and conservative treatment of 31 diabetic patients with foot ulcers and osteomielitis. There were 16 patients in surgical and 15 in conservative group. Mean age in both groups was similar (56.8 ± 6.9 years in the surgical group and 61.6 ± 10.4 years in the conservative group; p = 0.12) . Mean diabetes duration did not differ significantly between the groups (surgical group 16.0 ± 9.9 years and 12.8 ± 6.2 years; P = 0.35) nor did the diabetes control as assessed by HbA_1c level (mean HbA_1c level 8.3% ± 1.1 and 8.2% ± 1.02 recpectively; P = 0.97). The mean total healing time was similar in both treatment groups (surgical group 242.0 ± 133.6 days and conservative group 178 ± 60.8 days; p = 0.20). However when we compared the total healing time in conservatively treated group (178.5 ± 60.8 days range 108– –334 days) and the healing time of the wound after amputation in surgery patients (132.1 ± 102.2 days, range 39 do 480 days) the post-amputation healing time was significantly shorter (P = 0.004). Therefore we concluded that surgical intervention might be the better option for treatment of osteomyelitis in diabetic foot patients. The prospective randomized study is needed to confirm this observation.