Tratamiento y evolución de úlceras de pie diabético con sospecha de osteomielitis en una unidad de pie diabético de nueva creaciónestudio piloto observacional

  1. Mónica Arizmendi Pérez 1
  2. Esther Bravo Ruiz 1
  3. Raúl Torre Puente 1
  4. Josu Mirena Baraia-Etxaburu Artetxe 1
  5. Eider Etxeberria Martín 1
  6. Javier Pascual Huerta 1
  1. 1 OSI Bilbao-Basurto (Vizcaya). Hospital Universitario Basurto, Bilbao, España
Revue:
Revista española de podología

ISSN: 0210-1238

Année de publication: 2022

Volumen: 33

Número: 1

Pages: 29-34

Type: Article

DOI: 10.20986/REVESPPOD.2022.1624/2021 DIALNET GOOGLE SCHOLAR

D'autres publications dans: Revista española de podología

Objectifs de Développement Durable

Résumé

Objectives: Treatment of diabetic foot ulcers complicated with osteomyelitis (OM) is still a controversial issue. This work presents a case series showing the experience with these patients in a newly formed diabetic foot unit. Patients and methods: Patients with active foot ulcer and having the criteria of suspected OM (positive Probe to bone test with an image test, simple x-ray or MR, suggestive of OM) were analyzed retrospectively. Data of ulcer location, evolution time, soft tissue infection, peripheral arterial disease (PAD), treatments employed (antibiotics, dressings, offloading and/or revascularization) and final outcome (healed ulcer or not) were recorded and analyzed. Results: Twelve ulcer cases in 8 patients were included. Nine cases (75 %) were located in forefoot and 3 (25 %) in rearfoot. Five cases (42 %) had soft tissue infection, 6 (50 %) moderate and 1 (8 %) severe. The 66,7 % (n = 8) healed with conservative treatment (6 cases with antibiotics and offloading and 2 cases with offloading and no antibiotic therapy). Four cases (33,3 %) did not resolved and underwent amputation (2 mayor cases and 2 minor cases). Seventy-five percent of amputated cases (n = 3) had PAD. Conclusions: Despite the small sample size, this case series reflects that conservative treatment could be effective in these patients, it also shows the role of PAD in the final outcome of amputation and open new hypothesis about diagnoses and treatment for those patients.

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