Tardáguila-García Aroa, Sanz-Corbalán Irene, García-Alamino Josep M, Ahluwalia Raju, Uccioli Luigi, Lázaro-Martínez José Luis
Diabetic Foot Unit, Clínica Universitaria de Podología, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
GhenderS Research Group, Universidad Blanquerna-Ramon Llull, 08022 Barcelona, Spain.
J Clin Med. 2021 Mar 17;10(6):1237. doi: 10.3390/jcm10061237.
A systematic review and quality assessment was performed to assess the management of diabetic foot osteomyelitis by medical or surgical treatment. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was used. All selected studies were evaluated using the Cochrane Risk of Bias Tool to assess the risk of bias for randomized controlled trials. The literature was revised using PubMed (Medline) and Embase (Elsevier) up to September 2020 to identify clinical trials assessing medical or surgical treatment to manage diabetic foot osteomyelitis. A total of six clinical trials that met our inclusion criteria, with a total of 308 participants. Healing rate, complete closure of the wound, and type of complications were the outcomes evaluated. Risk of bias assessment showed that only two of the six clinical trials included in the systematic review had a low risk of bias. Based on our findings, we believe that the management of diabetic foot osteomyelitis remains challenging. There are few high-quality clinical trials that both stratify clinical presentations and compare these treatments. We conclude that the available evidence is insufficient to identify the best option to cure diabetic foot osteomyelitis.
进行了一项系统评价和质量评估，以评估糖尿病足骨髓炎的内科或外科治疗管理。使用了系统评价和Meta分析的首选报告项目（PRISMA）清单。所有选定的研究均使用Cochrane偏倚风险工具进行评估，以评估随机对照试验的偏倚风险。截至2020年9月，使用PubMed（Medline）和Embase（爱思唯尔）对文献进行了修订，以确定评估糖尿病足骨髓炎内科或外科治疗的临床试验。共有六项符合我们纳入标准的临床试验，共有308名参与者。评估的结果包括愈合率、伤口完全闭合情况和并发症类型。偏倚风险评估显示，系统评价中纳入的六项临床试验中只有两项偏倚风险较低。根据我们的研究结果，我们认为糖尿病足骨髓炎的管理仍然具有挑战性。很少有高质量的临床试验对临床表现进行分层并比较这些治疗方法。我们得出结论，现有证据不足以确定治愈糖尿病足骨髓炎的最佳选择。
