Treatment of Diabetic (Neuropathic) Foot Ulcers with Two-Stage Debridement and Closure
| Autor: | Timothy C. Fitzgibbons, Loree Henkel, Steven G. Kumagai, Scott T. McMullen, Craig R. Mahoney, Thomas L. Connolly |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors medicine.medical_treatment 03 medical and health sciences Wound care 0302 clinical medicine Biopsy medicine Humans Orthopedics and Sports Medicine Aged Retrospective Studies Aged 80 and over Wound Healing 030222 orthopedics Debridement medicine.diagnostic_test business.industry Osteomyelitis Suture Techniques Soft tissue Retrospective cohort study 030229 sport sciences Middle Aged medicine.disease Diabetic Foot Surgery Amputation Chronic Disease Female Wound healing business |
| Zdroj: | Foot & Ankle International. 19:160-165 |
| ISSN: | 1944-7876 1071-1007 |
| DOI: | 10.1177/107110079801900309 |
| Popis: | We reviewed 33 patients with 37 wounds treated between November of 1991 and December of 1995 in the Wound Care Center. A two-stage debridement and closure technique for neuropathic foot ulcers was performed. Patients selected included those with obvious osteomyelitis and those who had failed nonsurgical treatment. The approach included initial surgical excision of the ulcer with biopsy, bone resection with biopsy, and deep culture. The second-stage procedure 4 to 8 days later included debridement of the wound and delayed closure. Intravenous antibiotic treatment using a central line was given postoperatively in patients with documented osteomyelitis for at least 6 weeks and in patients with infected soft tissues only for about 4 weeks. All patients remained nonweightbearing for 4 weeks; this was felt necessary to prevent separation of the wound edges. Four wounds in four patients failed to heal, and two of these went on to amputation. Satisfactory healing occurred in 29 of 33 patients and in 33 of 37 wounds. The authors conclude that two-stage surgical debridement and closure is an acceptable treatment in selected nonhealing diabetic (neuropathic) foot ulcers. |
| Databáze: | OpenAIRE |
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