Combination of Open Subtotal Calcanectomy and Stabilization With External Fixation as Limb Salvage Procedure in Hindfoot-Infected Diabetic Foot Ulcers
| Autor: | Anna Carone, Luca Dalla Paola, Lucian Vasilache, Giuseppe Scavone, Giulio Boscarino |
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| Rok vydání: | 2016 |
| Předmět: |
diabetic foot surgery
medicine.medical_specialty Heel medicine.medical_treatment Limb Salvage Procedure foot infection Amputation Surgical 030218 nuclear medicine & medical imaging NO 03 medical and health sciences External fixation 0302 clinical medicine Negative-pressure wound therapy medicine Humans Prospective Studies diabetic foot ulcer osteomyelitis 030222 orthopedics Wound Healing business.industry Foot Osteomyelitis General Medicine medicine.disease Limb Salvage Diabetic foot Diabetic Foot Surgery medicine.anatomical_structure Diabetic foot ulcer Skin grafting business |
| Zdroj: | The international journal of lower extremity wounds. 15(4) |
| ISSN: | 1552-6941 |
| Popis: | Diabetic hindfoot ulcers, complicated by osteomyelitis, are associated with a high risk of major amputation. Partial calcanectomy, preceded by an effective management of the infection and of the eventual peripheral artery disease, can be considered as valid therapeutic option. We have evaluated a therapeutic protocol for diabetic hindfoot ulcers complicated by osteomyelitis, which, besides an adequate surgical debridement, considers a reconstructive pathway assisted by the positioning of a circular external fixator. We made a prospective study of a cohort of diabetic patients affected by heel ulcer complicated by osteomyelitis. All patients underwent open partial calcanectomy associated with the positioning of a circular external frame specifically designed for hindfoot stabilization and offloading. A reconstructive procedure was implemented starting with the application of negative pressure wound therapy and coverage with dermal substitute and split thickness skin grafting. From November 2014 to November 2015, 18 consecutive patients were enrolled. Mean follow-up period was 212.3 ± 64.0 days. Healing was achieved in 18 (100%) patients. The mean healing time was 69.0 ± 64.0 days. No major amputation had to be performed during the follow-up. Open partial calcanectomy associated with external fixation and skin reconstruction was as efficient as limb salvage in patients with infected lesions of the hindfoot complicated by calcaneal osteomyelitis. |
| Databáze: | OpenAIRE |
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