Osteomyelitis of the Foot and Ankle

Lindbloom, Benjamin J.; James, Eric R.; McGarvey, William C.

doi:10.1016/j.fcl.2014.06.012

Cited by 32 publications

(21 citation statements)

References 111 publications

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“…Kemik Biyopsisi: Kemik biyopsisi var olan tanı yöntem-leri içinde kemik infeksiyonunun histopatolojik tanısında olduğu kadar, infeksiyon etkeninin ve antibiyotik duyarlılığı-nın saptanmasında ve tedavinin belirlenmesinde en geçerli yöntemdir (45)(46)(47). Kemik dokusunun kültüründe üreme olmasının, osteomyelit tanısında yüksek bir duyarlılık (%92) ve özgüllüğe (%60) sahip olduğu gösterilmiştir (48).…”

Section: Soru 2: Osteomyelit Tanısında Hangi Laboratuvar Bulguları Yaunclassified

Diagnosis, Treatment and Prevention of Diabetic Foot Wounds and Infections: Turkish Consensus Report

Saltoğlu¹,

Kılıçoğlu²,

Baktiroğlu³

et al. 2016

Klimik Dergisi

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Study Group for Diabetic Foot Infections of the Turkish Society of Clinical Microbiology and Infectious Diseases has called for collaboration of the relevant specialist societies and the Ministry of Health to issue a national consensus report on the diagnosis, treatment and prevention of diabetic foot (DF) wounds and diabetic foot infections (DFIs) in Turkey. In the periodical meetings of the assigned representatives from all the parties, various questions as to pathogenesis, microbiology, assessment and grading, treatment, prevention and control of diabetic foot were identified. Upon reviewing related literature and international guidelines, these questions were provided

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Section: Soru 2: Osteomyelit Tanısında Hangi Laboratuvar Bulguları Yaunclassified

Diagnosis, Treatment and Prevention of Diabetic Foot Wounds and Infections: Turkish Consensus Report

Saltoğlu¹,

Kılıçoğlu²,

Baktiroğlu³

et al. 2016

Klimik Dergisi

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“…Conventional treatments include drainage, extensive debridement of all necrotic tissues, elimination of dead spaces, adequate soft-tissue coverage and systemic administration of antibiotics for four to six weeks. 26 However, systematic administration of antibiotics yields a limited success rate, which is mainly attributed to the limited blood supply and the formation of a bacteria biofilm that can prevent the infected area from acquiring sufficient antibiotics. 27 …”

Section: Discussionmentioning

confidence: 99%

Treatment of osteomyelitis defects by a vancomycin-loaded gelatin/β-tricalcium phosphate composite scaffold

Zhou

Wang

et al. 2018

Bone & Joint Research

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ObjectiveIn the present study, we aimed to assess whether gelatin/β-tricalcium phosphate (β-TCP) composite porous scaffolds could be used as a local controlled release system for vancomycin. We also investigated the efficiency of the scaffolds in eliminating infections and repairing osteomyelitis defects in rabbits.MethodsThe gelatin scaffolds containing differing amounts of of β-TCP (0%, 10%, 30% and 50%) were prepared for controlled release of vancomycin and were labelled G-TCP0, G-TCP1, G-TCP3 and G-TCP5, respectively. The Kirby-Bauer method was used to examine the release profile. Chronic osteomyelitis models of rabbits were established. After thorough debridement, the osteomyelitis defects were implanted with the scaffolds. Radiographs and histological examinations were carried out to investigate the efficiency of eliminating infections and repairing bone defects.ResultsThe prepared gelatin/β-TCP scaffolds exhibited a homogeneously interconnected 3D porous structure. The G-TCP0 scaffold exhibited the longest duration of vancomycin release with a release duration of eight weeks. With the increase of β-TCP contents, the release duration of the β-TCP-containing composite scaffolds was decreased. The complete release of vancomycin from the G-TCP5 scaffold was achieved within three weeks. In the treatment of osteomyelitis defects in rabbits, the G-TCP3 scaffold showed the most efficacious performance in eliminating infections and repairing bone defects.ConclusionsThe composite scaffolds could achieve local therapeutic drug levels over an extended duration. The G-TCP3 scaffold possessed the optimal porosity, interconnection and controlled release performance. Therefore, this scaffold could potentially be used in the treatment of chronic osteomyelitis defects.Cite this article: J. Zhou, X. G. Zhou, J. W. Wang, H. Zhou, J. Dong. Treatment of osteomyelitis defects by a vancomycin-loaded gelatin/β-tricalcium phosphate composite scaffold. Bone Joint Res 2018;7:46–57. DOI: 10.1302/2046-3758.71.BJR-2017-0129.R2.

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“…The results of this study confirmed the above-mentioned incidence of pathogens. Treatment options for diabetic hindfoot ulcers have less than full cure-rate efficacy and have great potential for chronic osteomyelitis and ultimately amputation [ 14 – 17 ]. Local wound care, hospitalization for intravenous antibiotic therapy, and serial surgical debridements of the necrotic tissues have been advocated in the literature to prevent amputation.…”

Section: Discussionmentioning

confidence: 99%

Partial calcanectomy and Ilizarov external fixation may reduce amputation need in severe diabetic calcaneal ulcers

Akkurt¹,

Demirkale

Öznur

2017

Diabetic Foot & Ankle

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Objective: The treatment of diabetic hindfoot ulcers is a challenging problem. In addition to serial surgical debridements, hyperbaric oxygen therapy and local wound care play important roles in the surgeon’s armamentarium, for both superficial infection and gangrene of the soft tissue, often complicated by osteomyelitis of the calcaneus. The purpose of this study was to evaluate the results of an aggressive approach from diagnosis to treatment of calcaneal osteomyelitis in foot-threatening diabetic calcaneal ulcers. Methods: The study included 23 patients with diabetic hindfoot ulcers who were treated with radical excision of the necrotic tissue and application of circular external fixation. The treatment protocol was a combination of magnetic resonance imaging (MRI)-guided debridement of the necrotic tissues and application of an Ilizarov external fixator in plantarflexion to decrease the soft-tissue defect. Primary outcome measures were total cure of infection and obvious healing of the osteomyelitis at 12 weeks determined by MRI, and clinical cure through objective assessment of the appearance of the wound. Results: The wounds healed in 18 of the 23 patients (78%), partial recovery occurred and subsequent flap operation was performed in three patients (13%), and below-the-knee amputation was performed in two patients (9%). Conclusions: This surgical protocol is effective in ameliorating diabetic hindfoot ulcers with concomitant calcaneal osteomyelitis, and satisfactorily reduces the need for amputation.

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Osteomyelitis of the Foot and Ankle

Cited by 32 publications

References 111 publications

Diagnosis, Treatment and Prevention of Diabetic Foot Wounds and Infections: Turkish Consensus Report

Diagnosis, Treatment and Prevention of Diabetic Foot Wounds and Infections: Turkish Consensus Report

Treatment of osteomyelitis defects by a vancomycin-loaded gelatin/β-tricalcium phosphate composite scaffold

Partial calcanectomy and Ilizarov external fixation may reduce amputation need in severe diabetic calcaneal ulcers

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