Infections With Pseudomonas Aeruginosa in Charcot Arthropathy of the Foot

Illgner, Ulrich; Uekoetter, Andreas; Runge, S.; Wetz, H. H.

doi:10.1177/1071100712464212

Cited by 9 publications

(3 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This correlates with findings by another Australian study that demonstrated P. aeruginosa to be more common in chronic wounds [43] and may reflect colonisation of chronic wounds over time. Other studies had also previously found P. aeruginosa to be associated with poorer outcomes [53,54] which may be due to an ability to impair wound healing [55], although it remains unclear whether P. aeruginosa is truly a causative factor in poor outcomes.…”

Section: Discussionmentioning

confidence: 99%

High burden of diabetic foot infections in the top end of Australia: An emerging health crisis (DEFINE study)

Commons

Robinson

Gawler

et al. 2015

Diabetes Research and Clinical Practice

View full text Add to dashboard Cite

Introduction-The risk of diabetes mellitus is increasing worldwide, and is particularly high in Indigenous Australians. Complicated foot infection is one of the most common sequelae of diabetes. We describe the incidence and associations of Indigenous and non-Indigenous inpatients with diabetic foot infections at Royal Darwin Hospital.Methods-All adult Royal Darwin Hospital inpatients with diabetic foot infections were enrolled prospectively from September 2012 to November 2013. Incidence, demographics, microbiology, management and clinical outcomes were analysed by Indigenous status, and association with methicillin resistant Staphylococcus aureus and Pseudomonas aeruginosa.Results-There were 245 separate hospital admissions in 177 patients with an incidence of 79 admissions per 100,000 person years. Patients occupied a mean of 19.4 hospital beds each day. Compared to the non-Indigenous population, Indigenous patients had a greater incidence of admission (Rate Ratio (RR) = 5.1, [95%CI = 3.8, 7.0]), were younger (mean difference of 11.1 years; p < 0.001), and more likely to undergo major and minor amputations (RR = 4.1 [95%CI = 1.6, 10.7], and 6.2 [95%CI = 3.5, 11.1] respectively). Non-multiresistant methicillin resistant S. Conclusions-This study highlights a rising burden of diabetic foot infections in the Top End of Australia, with a four-fold increase in bed days since 2002 and an overrepresentation in the Indigenous population. Europe PMC Funders Group

show abstract

Section: Discussionmentioning

confidence: 99%

High burden of diabetic foot infections in the top end of Australia: An emerging health crisis (DEFINE study)

Commons

Robinson

Gawler

et al. 2015

Diabetes Research and Clinical Practice

View full text Add to dashboard Cite

show abstract

“…The treatment and reconstruction of Charcot feet remains a surgical challenge. Most cases exhibit atypical, multidirectional destruction and instability, often combined with major bone loss and ulceration with infection[ 7 ]. In addition, most patients have comorbidities and suffer from diabetes mellitus, nephropathy, and/or peripheral vascular disease.…”

Section: Introductionmentioning

confidence: 99%

“…Longer operative duration, hemoglobin A1c levels >7 mg/dl, and peripheral neuropathy elevate complication rates, especially regarding wound healing and infections[ 8 , 9 ]. Infections with P. aeruginosa in particular have been associated with poor outcomes[ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical benefit and improvement of activity level after reconstruction surgery of Charcot feet using external fixation: 24-months results of 292 feet

Illgner

Budny

Frohne

et al. 2014

BMC Musculoskelet Disord

Self Cite

View full text Add to dashboard Cite

BackgroundReconstruction of Charcot feet remains a surgical challenge. The goal of this study was to investigate safety and clinical benefit from reconstruction of Charcot feet using an external fixator. There is limited valid data regarding long-term outcomes for Charcot foot procedures.MethodsIn a retrospective study, 292 Charcot feet (282 patients) undergoing reconstructive procedures in our clinic from 1996–2010 were included (93 female, 189 male, mean age 57.9 years). Average follow-up was 24.1 months. Exclusion criteria were previous major amputation on the same side. All patients underwent surgery using a Hoffmann II external fixator for six to eight weeks with offloading. The fixator was then removed, and a customized AFO with full weight bearing was applied for another 11 months. After one year, patients received customized orthopedic shoes.ResultsInitial amputations were avoided. Patient activity improved significantly by more than 1 level (SD 0.67, p < .001) according to the Hoffer activity score for lower limb amputees. The most common minor complication was persistent or recurrent ulceration in 67 feet (23%). Secondary amputation (after failure of external fixation) was required in only 12 patients (6.2%). Orthopedic shoes were used by approximately 34% of patients 18 months after surgery.ConclusionsReconstructive surgery of Charcot feet using external fixation is a safe and economically feasible procedure. Activity levels improved significantly by more than 1 level (p < 0.01), severe complications were rare, and secondary amputation was required in only 12 patients (6.2%) of a high-risk patient population. Use of an external fixator offers the advantage that all extraneous material is removed after six weeks; thus, there is no risk of broken screws or plates and the associated potential complications.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2474-15-392) contains supplementary material, which is available to authorized users.

show abstract