Optimal management of diabetic foot osteomyelitis: challenges and solutions

José Luis Lázaro Martínez, Yolanda García Álvarez, Aroa Tardáguila-García, Esther García MoralesInstituto de Investigación Sanitaria del Hospital Clínico San Carlos, Universidad Complutense...

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Autores principales:	Lázaro Martínez JL, García Álvarez Y, Tardáguila-García A, García Morales E
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	diabetic foot diabetic foot infection bone infection diabetic foot ulcers Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/63b9d33864434173880ced8fc2d69d0a
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spelling	oai:doaj.org-article:63b9d33864434173880ced8fc2d69d0a2021-12-02T04:53:12ZOptimal management of diabetic foot osteomyelitis: challenges and solutions1178-7007https://doaj.org/article/63b9d33864434173880ced8fc2d69d0a2019-06-01T00:00:00Zhttps://www.dovepress.com/optimal-management-of-diabetic-foot-osteomyelitis-challenges-and-solut-peer-reviewed-article-DMSOhttps://doaj.org/toc/1178-7007José Luis Lázaro Martínez, Yolanda García Álvarez, Aroa Tardáguila-García, Esther García MoralesInstituto de Investigación Sanitaria del Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid 28040, SpainPurpose: Diabetic foot osteomyelitis (DFO) is the most frequent infection associated with diabetic foot ulcers, occurs in >20% of moderate infections and 50%–60% of severe infections, and is associated with high rates of amputation. DFO represents a challenge in both diagnosis and therapy, and many consequences of its condition are related to late diagnosis, delayed referral, or ill-indicated treatment. This review aimed to analyze the current evidence on DFO management and to discuss advantages and disadvantages of different treatment options.Methods: A narrative review of the evidence was begun by searching Medline and PubMed databases for studies using the keywords “management”, “diabetic foot”, “osteomyelitis”, and “diabetic foot osteomyelitis” from 2008 to 2018.Results: We found a great variety of studies focusing on both medical and surgical therapies showing a similar rate of effectiveness and outcomes; however, the main factors in choosing one over the other seem to be associated with the presence of soft-tissue infection or ischemia and the clinical presentation of DFO.Conclusion: Further randomized controlled trials with large samples and long-term follow-up are necessary to demonstrate secondary outcomes, such as recurrence, recurrent ulceration, and reinfection associated with both medical and surgical options.Keywords: diabetic foot, diabetic foot infection, bone infection, diabetic foot ulcersLázaro Martínez JLGarcía Álvarez YTardáguila-García AGarcía Morales EDove Medical Pressarticlediabetic footdiabetic foot infectionbone infectiondiabetic foot ulcersSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol Volume 12, Pp 947-959 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	diabetic foot diabetic foot infection bone infection diabetic foot ulcers Specialties of internal medicine RC581-951
spellingShingle	diabetic foot diabetic foot infection bone infection diabetic foot ulcers Specialties of internal medicine RC581-951 Lázaro Martínez JL García Álvarez Y Tardáguila-García A García Morales E Optimal management of diabetic foot osteomyelitis: challenges and solutions
description	José Luis Lázaro Martínez, Yolanda García Álvarez, Aroa Tardáguila-García, Esther García MoralesInstituto de Investigación Sanitaria del Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid 28040, SpainPurpose: Diabetic foot osteomyelitis (DFO) is the most frequent infection associated with diabetic foot ulcers, occurs in >20% of moderate infections and 50%–60% of severe infections, and is associated with high rates of amputation. DFO represents a challenge in both diagnosis and therapy, and many consequences of its condition are related to late diagnosis, delayed referral, or ill-indicated treatment. This review aimed to analyze the current evidence on DFO management and to discuss advantages and disadvantages of different treatment options.Methods: A narrative review of the evidence was begun by searching Medline and PubMed databases for studies using the keywords “management”, “diabetic foot”, “osteomyelitis”, and “diabetic foot osteomyelitis” from 2008 to 2018.Results: We found a great variety of studies focusing on both medical and surgical therapies showing a similar rate of effectiveness and outcomes; however, the main factors in choosing one over the other seem to be associated with the presence of soft-tissue infection or ischemia and the clinical presentation of DFO.Conclusion: Further randomized controlled trials with large samples and long-term follow-up are necessary to demonstrate secondary outcomes, such as recurrence, recurrent ulceration, and reinfection associated with both medical and surgical options.Keywords: diabetic foot, diabetic foot infection, bone infection, diabetic foot ulcers
format	article
author	Lázaro Martínez JL García Álvarez Y Tardáguila-García A García Morales E
author_facet	Lázaro Martínez JL García Álvarez Y Tardáguila-García A García Morales E
author_sort	Lázaro Martínez JL
title	Optimal management of diabetic foot osteomyelitis: challenges and solutions
title_short	Optimal management of diabetic foot osteomyelitis: challenges and solutions
title_full	Optimal management of diabetic foot osteomyelitis: challenges and solutions
title_fullStr	Optimal management of diabetic foot osteomyelitis: challenges and solutions
title_full_unstemmed	Optimal management of diabetic foot osteomyelitis: challenges and solutions
title_sort	optimal management of diabetic foot osteomyelitis: challenges and solutions
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/63b9d33864434173880ced8fc2d69d0a
work_keys_str_mv	AT lazaromartinezjl optimalmanagementofdiabeticfootosteomyelitischallengesandsolutions AT garciaalvarezy optimalmanagementofdiabeticfootosteomyelitischallengesandsolutions AT tardaguilagarciaa optimalmanagementofdiabeticfootosteomyelitischallengesandsolutions AT garciamoralese optimalmanagementofdiabeticfootosteomyelitischallengesandsolutions
_version_	1718401008586981376

Optimal management of diabetic foot osteomyelitis: challenges and solutions

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