Addenbrooke's Hospital, Orthopaedic Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Bone Joint J. 2013 Aug;95-B(8):1083-7. doi: 10.1302/0301-620X.95B8.31280.
Limited forefoot amputation in diabetic patients with osteomyelitis is frequently required. We retrospectively reviewed diabetic patients with osteomyelitis, an unhealed ulcer and blood pressure in the toe of > 45 mmHg who underwent limited amputation of the foot with primary wound closure. Between 2006 and 2012, 74 consecutive patients with a mean age of 67 years (29 to 93), and a median follow-up of 31 months, were included. All the wounds healed primarily at a median of 37 days (13 to 210; mean 48). At a median of 6 months (1.5 to 18; mean 353 days), 23 patients (31%) suffered a further ulceration. Of these, 12 patients (16% of the total) required a further amputation. We conclude that primary wound closure following limited amputation of the foot in patients with diabetes is a safe and effective technique when associated with appropriate antibiotic treatment.
对于患有骨髓炎且足部溃疡未愈合且趾部血压>45mmHg 的糖尿病患者，通常需要进行有限的足部截肢。我们回顾性分析了 2006 年至 2012 年间 74 例连续糖尿病骨髓炎患者，这些患者行足部有限截肢术并一期闭合伤口，患者平均年龄 67 岁（29 岁至 93 岁），中位随访时间 31 个月。所有伤口均在中位时间 37 天（13 天至 210 天；平均 48 天）一期愈合。中位时间 6 个月（1.5 至 18 个月；平均 353 天）时，23 例患者（31%）再次出现溃疡。其中 12 例患者（占总数的 16%）需要进一步截肢。我们得出结论，对于糖尿病患者，在适当的抗生素治疗的前提下，足部有限截肢术后一期闭合伤口是一种安全有效的技术。
