Diabetic Foot Unit, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
Int Wound J. 2019 Apr;16(2):467-472. doi: 10.1111/iwj.13055. Epub 2018 Dec 26.
The aim of this study was to evaluate the recovery time and the development of complications in the dorsal and plantar approach to metatarsal head resections (MHR) in patients with diabetic foot ulcers complicated by osteomyelitis. A retrospective study was carried out involving 108 patients who underwent MHRs for the treatment of diabetic foot osteomyelitis. Two cohorts were defined: dorsal approach with incision closed with sutures and plantar approach with ulcer healed using conservative treatment. The main outcomes were the weeks until healing and complications related to the approaches. Fifty-three patients (49.1%) underwent a plantar approach and 55 (50.9%) a dorsal approach. Both approaches rendered similar healing times. However, the patients undergoing a dorsal approach developed more post-surgical complications than patients treated through a plantar approach. The dorsal approach intervention was performed on smaller and shallower ulcers; however, more complications developed at follow up using this approach than through a plantar approach for MHR complicated with osteomyelitis.
本研究旨在评估背侧和足底入路治疗伴有骨髓炎的糖尿病足溃疡跖骨头切除术（MHR）的恢复时间和并发症发展情况。对 108 例接受 MHR 治疗糖尿病足骨髓炎的患者进行回顾性研究。定义了两个队列：采用缝合闭合切口的背侧入路和采用保守治疗使溃疡愈合的足底入路。主要结局是愈合所需的周数和与入路相关的并发症。53 例（49.1%）患者采用足底入路，55 例（50.9%）患者采用背侧入路。两种入路的愈合时间相似。然而，行背侧入路的患者比行足底入路的患者发生更多的术后并发症。背侧入路干预应用于较小且较浅的溃疡；然而，与足底入路相比，随访时通过背侧入路治疗伴有骨髓炎的 MHR 会出现更多并发症。
