Treatment of Osteomyelitis in the Diabetic Foot: Contribution of conservative surgery

Georges Ha Van; Hubert Siney; Jean-Paul Danan; Claude Sachon; André Grimaldi

doi:10.2337/diacare.19.11.1257

Original Articles

Treatment of Osteomyelitis in the Diabetic Foot: Contribution of conservative surgery

Georges Ha Van, MD,
Hubert Siney, MD,
Jean-Paul Danan, MD,
Claude Sachon, MD and
André Grimaldi, MD

Department of Diabetology and Metabolism, Hôpital Saint-Vincent-de-Paul Paris, France
Groupe Hospitalier Pitié Salpétriere, and the Computer Sciences Department, Hôpital Saint-Vincent-de-Paul Paris, France

Address correspondence and reprint requests to Georges Ha Van, Service de Diabétologie Métabolisme, MD, Groupe Hospitalier Pitié-Salpétrière, 47–83 Boulevard de l'Hôpital, 75013 Paris, France.

Diabetes Care 1996 Nov; 19(11): 1257-1260. https://doi.org/10.2337/diacare.19.11.1257

Abstract

OBJECTIVE To compare the duration of healing of foot ulcers with osteomyelitis in diabetic patients treated by medical treatment versus medical treatment associated with conservative orthopedic surgery.

RESEARCH DESIGN AND METHODS We entered into the study 67 diabetic patients who had a foot ulcer with osteomyelitis without ischemia requiring a peripheral arterial reconstruction. Thirty-two diabetic patients were included in a first historic group from 1986 to 1993, treated by antibiotic therapy, offloading, and wound care. Thirty-two patients were included from September 1993 to March 1995, treated by the same medical treatment and conservative orthopedic surgery.

RESULTS The healing rate was 57% in the group treated by the medical treatment alone versus 78% in the surgical group (P < 0.008). The duration of healing was 462 ± 98 days versus 181 ± 30 days (P < 0.008).

CONCLUSIONS Conservative surgery contributes to an increase in the healing rate of foot ulcers with osteomyelitis compared with a medical treatment alone.