Surgery with void filler for diabetic foot infection may increase limb salvage rate
Click Here to Manage Email Alerts
Key takeaways:
- Patients with diabetic foot infection had a 95% limb salvage rate with local antibiotic-loaded hydroxyapatite and calcium sulfate biocomposite void filler.
- Revascularization yielded a longer healing time.
SAN FRANCISCO — Results showed use of local antibiotic-loaded hydroxyapatite and calcium sulfate biocomposite void filler may increase limb salvage and ulcer healing rates among patients with diabetic foot infections and vascular disease.
Emma Fossett, MSc, BS, MBBS, and colleagues retrospectively reviewed data on 20 patients with peripheral vascular disease who underwent surgical management of diabetic foot infections at a tertiary referral multidisciplinary diabetic foot unit between 2020 and 2023. Inclusion criteria included diabetic ulcers, osteomyelitis, intraoperative intraosseous and soft tissue application of an antibiotic-loaded hydroxyapatite and calcium sulfate biocomposite void filler.
According to Fossett, 50% of patients required revascularization surgery prior to surgical intervention and 77% of patients already had ipsilateral debridement or amputation. She added 91% of patients had ulcers, with most being grade 3 affecting the forefoot; while 100% of patients had osteomyelitis, with most cases affecting the metatarsals.
“Our average healing time was 19 weeks, with forefoot ulcers healing quicker than the hindfoot and midfoot ulcers combined,” Fossett said. “Our grade 1 and 2 ulcers also healed quicker than grade 3.”
Patients who required revascularization experienced a healing time 2 months longer compared with patients who did not require revascularization, Fossett said.
“Eighty-two percent of our ulcers fully healed, and we had a 95% limb salvage rate with one patient requiring amputation, but this was due to vascular graft complications rather than infection,” Fossett said. “Three patients required more than one procedure to facilitate healing.”
Collapse
Fossett E, et al. Paper 149. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; Feb. 21-16, 2024; San Francisco.
Click Here to Manage Email Alerts