Aragón-Sánchez Javier, Víquez-Molina Gerardo, López-Valverde María Eugenia, Rojas-Bonilla José María, Murillo-Vargas Christian
La Paloma Hospital, Las Palmas de Gran Canaria, Spain.
San Juan de Dios Hospital, San José de Costa Rica, Costa Rica.
Int J Low Extrem Wounds. 2023 Mar;22(1):36-43. doi: 10.1177/1534734620986695. Epub 2021 Feb 2.
It has been reported that patients with diabetes and foot ulcers complicated with osteomyelitis (OM) have a worse prognosis than those complicated with soft tissue infections (STI). Our study aimed to determine whether OM is associated with a worse prognosis in cases of moderate and severe diabetic foot infections requiring surgery. A retrospective series consisted of 150 patients who underwent surgery for diabetic foot infections. We studied the differences between OM versus STI. Furthermore, diabetic foot infections were reclassified into four groups: moderate STI (M-STI), moderate OM (M-OM), severe STI (S-STI), and severe OM (S-OM). The variables associated with prognosis were limb loss, length of hospital stay, duration of antibiotic treatment, recurrence of the infection, and time to healing (both the initial ulcer and the postoperative wound). No differences in limb salvage, hospital stay, duration of antibiotic treatment, recurrence of the infection, and time to healing were found when comparing OM with STI. Patients with M-O had a higher rate of recurrences after initial treatment and a longer time to healing when comparing with M-STI. We didn't find any differences between severe infections with or without OM. In conclusion, we have found in our surgical series of diabetic foot infections that OM is not associated with worse prognosis when comparing with STI regarding limb loss rate, length of hospital stays, duration of antibiotic treatment, recurrence of the infection, and time to healing. The results of the present series should further be confirmed by other authors.
据报道，患有糖尿病且足部溃疡并发骨髓炎（OM）的患者比并发软组织感染（STI）的患者预后更差。我们的研究旨在确定在需要手术治疗的中度和重度糖尿病足部感染病例中，OM是否与更差的预后相关。一项回顾性研究纳入了150例接受糖尿病足部感染手术的患者。我们研究了OM与STI之间的差异。此外，糖尿病足部感染被重新分为四组：中度STI（M-STI）、中度OM（M-OM）、重度STI（S-STI）和重度OM（S-OM）。与预后相关的变量包括肢体缺失、住院时间、抗生素治疗持续时间、感染复发以及愈合时间（包括初始溃疡和术后伤口的愈合时间）。比较OM与STI时，在肢体保全、住院时间、抗生素治疗持续时间、感染复发以及愈合时间方面未发现差异。与M-STI相比，M-O患者初始治疗后的复发率更高，愈合时间更长。我们未发现伴有或不伴有OM的严重感染之间存在任何差异。总之，在我们的糖尿病足部感染手术系列研究中发现，与STI相比，在肢体缺失率、住院时间、抗生素治疗持续时间、感染复发以及愈合时间方面，OM与更差的预后无关。本系列研究结果应由其他作者进一步证实。
