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Clinical characteristics and outcome in 223 diabetic patients with deep foot infections

Author:
  • Magnus Eneroth
  • Jan Apelqvist
  • Anders Stenström
Publishing year: 1997-11
Language: English
Pages: 716-722
Publication/Series: Foot and Ankle International
Volume: 18
Issue: 11
Document type: Journal article
Publisher: Williams & Wilkins

Abstract english

Clinical characteristics and outcome in 223 consecutive diabetic patients with deep foot infections are reported. Patients were treated by a multidisciplinary diabetic foot-care team at the University Hospital, Lund, Sweden, and were prospectively followed until healing or death. About 50% of patients lacked clinical signs of infection, such as a body temperature > 37.8°C, a sedimentation rate > 70 mm/hour, and white blood cell count (WBC) > 10 x 109/liter. Eighty-six percent had surgery before healing or death. Thirty-nine percent healed without amputation; 34% healed after a minor and 8% after a major amputation. Sixteen percent were unhealed at death, and 3% were unhealed at the end of the observation period. Of those unhealed at death or follow-up, 4 patients had had a major and 11 a minor amputation. After correction for age and sex, duration of diabetes < 14 years, palpable popliteal pulse, a toe pressure > 45 mmHg, and an ankle pressure > 80 mm Hg, absence of exposed bone and a white blood cell count < 12 x 109/liter were all related to healing without amputation in a logistic regression analysis. We conclude that although only 1 in 10 had a major amputation, nearly all diabetic patients with a deep foot infection needed surgery and more than one third had a minor amputation before healing or death in spite of a well- functioning diabetic foot-care team responsible for all included patients.

Keywords

  • Orthopedics
  • Endocrinology and Diabetes

Other

Published
  • ISSN: 1071-1007
E-mail: jan [dot] apelqvist [at] med [dot] lu [dot] se

Physician

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