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Limb salvage in severe diabetic foot infection

Authors
 Bom Soo Kim  ;  Woo Jin Choi  ;  Mi Kyung Baek  ;  Yong Sang Kim  ;  Jin Woo Lee 
Citation
 FOOT & ANKLE INTERNATIONAL, Vol.32(1) : 31-37, 2011 
Journal Title
FOOT & ANKLE INTERNATIONAL
ISSN
 1071-1007 
Issue Date
2011
MeSH
Algorithms ; Amputation/statistics & numerical data ; Debridement ; Diabetic Foot/microbiology* ; Female ; Follow-Up Studies ; Humans ; Limb Salvage* ; Male ; Middle Aged ; Negative-Pressure Wound Therapy* ; Osteomyelitis/therapy* ; Retrospective Studies ; Soft Tissue Infections/therapy* ; Wound Healing
Keywords
Diabetic Foot ; Infection ; Amputation ; Limb Salvage ; Negative Pressure Wound Therapy
Abstract
BACKGROUND: The purpose of our study was to determine the efficacy of a management algorithm that includes negative pressure wound therapy (NPWT) in diabetic feet with limb-threatening infection.

MATERIALS AND METHODS: Forty-five septic diabetic feet were treated with NPWT between 2006 and 2008. After emergent abscess evacuation, early vascular intervention was performed if necessary. Debridement, with or without partial foot amputation, was followed by NPWT. Wound progress was measured using a digital scanner. A limb was considered salvaged if complete healing was achieved without any or with minor amputation through or below the ankle. The mean followup after complete wound healing was 17 (range, 6 to 35) months.

RESULTS: Thirty-two cases (71%) were infected with two or more organisms. Negative pressure wound therapy was applied for 26.2±14.3 days. The median time to achieve more than 75% wound area granulation was 23 (range, 4 to 55) days and 104 (range, 38 to 255) days to complete wound healing. Successful limb salvage was achieved in 44 cases (98%); 14 (31%) without any amputation and 30 (67%) with partial foot amputations. Total number of operations per limb was 2.4±1.3. One case of repeated infection and necrosis was managed with a transtibial amputation. There were no complications associated with NPWT.

CONCLUSION: This study provides the outcome of a management algorithm which includes NPWT in salvaging severely infected diabetic feet. With emergent evacuation of abscess, early vascular intervention and appropriate debridement, NPWT can be a useful adjunct to the management of limb-threatening diabetic foot infections.
Full Text
http://fai.sagepub.com/content/32/1/31
DOI
10.3113/FAI.2011.0031
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Bom Soo(김범수)
Kim, Yong Sang(김용상)
Lee, Jin Woo(이진우) ORCID logo https://orcid.org/0000-0002-0293-9017
Choi, Woo Jin(최우진)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/93122
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