The impact of residual diabetic toe osteomyelitis at the conservative surgical resection margins on prognosis

IF 3.4 3区医学 Q2 ENDOCRINOLOGY & METABOLISM Diabetic Medicine Pub Date : 2024-12-19 DOI:10.1111/dme.15502

Haojie Sun, Weidong Deng, Shanwen Si, Xuekui Liu, Houfa Geng, Jun Liang

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Abstract

Aims

The study is to investigate how residual osteomyelitis at conservative surgical resection margins affects the prognosis of diabetic toe osteomyelitis.

Methods

In this retrospective study, 67 participants with diabetic toe osteomyelitis who underwent conservative surgery were evaluated. The diagnosis of osteomyelitis was based on histopathology, and bone histopathology was done on the resection bone. After discharge, a 16-week follow-up was conducted, focusing on the wound healing time as the primary outcome. Cox regression analysis was employed as the primary method to analyse the risk factors that influence wound healing.

Results

Among the 67 participants, 48 (71.6%) had positive bone margins, while 19 (28.4%) had negative bone margins. Participants with positive bone margins experienced an average healing time of 60.78 ± 18.50 days, whereas those with negative bone margins had an average healing time of 55.19 ± 14.60 days (p = 0.285). Bone margins (positive vs. negative) did not have an impact on wound healing (HR, 1.195 [95% CI, 0.668–2.136]; p = 0.549). Ankle-brachial index was identified as a factor influencing wound healing (HR, 5.399 [95% CI, 1.145–25.455]; p = 0.033). There was no statistical difference between the two groups in terms of wound healing rates (40 of 48 [83.3%] vs. 16 of 19 [84.2%], p = 0.93), inpatient days (19.48 ± 5.25 vs. 18.26 ± 4.79 days, p = 0.385) and duration of antibiotics (32.33 ± 5.64 vs. 30.53 ± 6.93 days, p = 0.272).

Conclusion

The residual osteomyelitis in diabetic toe osteomyelitis post-conservative surgery does not impact the wound healing.

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保守手术切缘残余糖尿病脚趾骨髓炎对预后的影响。

目的：探讨保守手术切缘残余骨髓炎对糖尿病足骨髓炎患者预后的影响。方法：在这项回顾性研究中，对67例接受保守手术的糖尿病脚趾骨髓炎患者进行评估。骨髓炎的诊断以组织病理学为依据，切除骨行骨组织病理学检查。出院后随访16周，以创面愈合时间为主要观察指标。采用Cox回归分析作为主要方法分析影响创面愈合的危险因素。结果：67例患者中，48例（71.6%）骨缘阳性，19例（28.4%）骨缘阴性。骨缘阳性患者的平均愈合时间为60.78±18.50天，而骨缘阴性患者的平均愈合时间为55.19±14.60天（p = 0.285）。骨缘（阳性与阴性）对伤口愈合没有影响(HR, 1.195 [95% CI, 0.668-2.136]；p = 0.549)。踝肱指数被认为是影响伤口愈合的因素(HR, 5.399 [95% CI, 1.145-25.455]；p = 0.033)。两组患者伤口愈合率（48例中40例[83.3%]比19例中16例[84.2%],p = 0.93）、住院天数（19.48±5.25天比18.26±4.79天，p = 0.385）、抗生素使用时间（32.33±5.64天比30.53±6.93天，p = 0.272）差异无统计学意义。结论：糖尿病足趾骨髓炎保守手术后残余骨髓炎不影响创面愈合。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetic Medicine 医学-内分泌学与代谢

CiteScore

7.20

自引率

5.70%

发文量

229

审稿时长

3-6 weeks

期刊介绍： Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions. The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed. We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services. Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”