Surgical treatment of osteomyelitis in patients with diabetic foot: clinical experience

Abstract

Aim. To analyse the results of surgical treatment of osteomyelitis in patients with diabetic foot.Methods. A retrospective analytical study was conducted to assess the outcomes of surgical treatment for osteomyelitis in diabetic foot patients. The study analysed 28 patients with osteomyelitis classified as Grade III according to the Wagner classification. The average age of the participants was 62.5 ± 14.5 years, and the mean duration of diabetes mellitus was 8.2 ± 5.5 years. The cohort consisted of 16 men (67.1 %) and 12 women (32.9 %). All patients presented with a single osteomyelitic lesion located in the anterior region of the foot. The underlying causes of osteomyelitis included trophic ulcers and complications such as abscesses of the toes and phlegmon of the foot, which developed secondary to the trophic ulcers.Results. In the group of patients who underwent both autopsy and drainage of abscesses and phlegmon, followed by one-stage amputation of one or more toes with radical resection of the corresponding metatarsal heads, the average number of hospital bed days was 31.9 ± 15.7. In contrast, the group of patients who were admitted without purulent necrotic complications and underwent one-stage amputation of one or more toes with radical resection of the metatarsal heads had an average of 13.4 ± 2.1 bed days.Conclusion. Prolongation of medical treatment in patients with osteomyelitis of the diabetic foot, leading to the occurrence of purulent-necrotic complications, doubles the length of hospital stay, which entails an increase in treatment costs.