Diabetes is a fast-growing chronic metabolic disorder that is widely associated with foot ulcers. The major challenge among these ulcers is wound infections, altered inflammatory responses, and a lack of angiogenesis that can complicate limb amputation. The foot, because of its architecture, becomes the part most prone to complications and the infection rate is higher mainly between the toes due to the humid nature. Therefore, the infection rate is significantly higher. Wound healing in diabetes is a dynamic process usually delayed due to poor immune function. Diabetes-related pedal neuropathy and perfusion disturbances can lead to a loss of sensation in the foot. This neuropathy can further be a risk factor for ulcer development due to repetitive mechanical stress that later might get infected by the invasion of microorganisms extending to the bone and causing an infection called pedal osteomyelitis. This review details the pathophysiology, the biomaterials aiding in the infection cure and regeneration of bone along with their limitations, as well as their future prospects.
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http://dx.doi.org/10.4068/cmj.2023.59.2.109 | DOI Listing |
Background: Kyphoplasty (KP) is a well-established procedure with a low complication risk, however, the procedure's safety in patients with comorbidities and in the setting of systemic infection remains uncertain with no clear guidelines. We present a unique case of KP in the setting of recurrent septicemia, which required subsequent salvage vertebrectomy.
Case Description: We present a clinical case of a 59-year-old diabetic male patient with a recent foot ulcer, positive for and .
Adv Skin Wound Care
January 2025
At Baylor College of Medicine, Houston, Texas, United States, Livia Frost, BS, is Medical Student, School of Medicine; Ya Xu, MD, PhD, is Assistant Professor, Department of Pathology & Immunology; and Yuriko Fukuta, MD, PhD, CWSP, is Assistant Professor, Department of Medicine, Section of Infectious Diseases.
Diabetic foot bacterial osteomyelitis is a serious infection that can lead to major amputations. However, fungal osteomyelitis in a diabetic foot ulcer is uncommon and has been underrecognized. It typically occurs in patients with underlying immunocompromised status and is associated with poor outcomes.
View Article and Find Full Text PDFInt J Low Extrem Wounds
January 2025
Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Our objective was to compare clinical outcomes in diabetic foot ulcers (DFU) treated with AmnioExcel applied weekly (AMX1) or biweekly (AMX2) over a 12-week evaluation period. This randomized clinical trial evaluated 40 people with UT 1A and 1D DFUs >30 days but less than 6 months duration and age >21 years. We excluded patients with untreated osteomyelitis, gangrene, widespread malignancy, or active substance abuse.
View Article and Find Full Text PDFInt J Low Extrem Wounds
January 2025
Diabetic foot Unit, San Juan de Dios Hospital, San José de Costa Rica, Costa Rica.
Diabetes-related foot osteomyelitis (DFO) can present as an acute condition with soft tissue involvement or as a non-acute form characterized by long-standing ulcers without immediate limb-threatening features. This study evaluates infection relapse and healing times after conservative surgery in non-acute DFO, with a focus on osteomyelitis localization. A retrospective cohort of 60 patients treated for forefoot DFO without soft tissue involvement or necrosis was analyzed.
View Article and Find Full Text PDFAntibiotics (Basel)
December 2024
Division of Infectious Diseases, Department Internal Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands.
The optimal antimicrobial treatment duration for diabetes-related foot osteomyelitis (DFO) currently needs to be determined. We systematically reviewed the effects of short and long treatment durations on outcomes of DFO. We performed a systematic review searching Cochrane, CENTRAL, MEDLINE, Embase, and CINAHL Plus from inception up to 19 January 2024.
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