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首页> 外文期刊>Journal of Clinical Medicine >Multidisciplinary Approach for the Management and Treatment of Diabetic Foot Infections with a Resorbable, Gentamicin-Loaded Bone Graft Substitute
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Multidisciplinary Approach for the Management and Treatment of Diabetic Foot Infections with a Resorbable, Gentamicin-Loaded Bone Graft Substitute

机译：糖尿病脚感染的管理和治疗多学科方法，可再吸收，庆大霉素骨移植替代品

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摘要

Diabetic patients are at increased risk of developing foot ulcers which may cause bone infections associated with a high probability of both amputation and mortality. Therefore, prompt diagnosis and adequate treatment are of key importance. In our Diabetic Foot Unit, effective multidisciplinary treatment of osteomyelitis secondary to diabetes involves the application of a gentamicin-eluting calcium sulphate/hydroxyapatite bone graft substitute to fill residual bone voids after debridement. The data of all patients treated with the gentamicin-eluting calcium sulphate/hydroxyapatite bone graft substitute for diabetic foot infections with ulcer formation and osteomyelitis at metatarsals, calcaneus and hindfoot at our institute from July 2013 to September 2016 were retrospectively collected and evaluated. A total of 35 patients were included in this retrospective single-arm case series and were either continuously followed up for at least one year or until healing was confirmed. Nineteen lesions affected the distal row of tarsus/talus, ten the calcaneus and a further six were located at the metatarsals. While all of the metatarsal lesions had healed at 1-year follow-up, the healing rate in the hindfoot region was lower with 62.5% at the calcaneus and 72.2% at the distal tarsus and talus at 12 months, respectively. The overall cure rate for ulcerous bone infection was 81.3%. In two calcaneal lesions (25%) and two lesions of distal tarsus/talus (11.1%) amputation was considered clinically necessary. Promising results were achieved in the treatment of diabetic foot infections with soft tissue ulcers by a multidisciplinary approach involving extensive debridement followed by adequate dead space management with a resorbable gentamicin-eluting bone graft substitute.
机译：糖尿病患者的风险增加了发展足部溃疡，这可能导致骨感染与截肢和死亡率的高概率相关。因此，提示诊断和充分的治疗具有重要意义。在我们的糖尿病足部单元中，患糖尿病的骨髓炎的有效多学科治疗涉及在清除后涂覆庆大霉素洗脱氧化钙/羟基磷灰石骨移植物以填充残留的骨空隙。从2013年7月至2016年7月至2016年7月，在2013年7月至2016年9月，在2013年7月至2016年9月，在2013年7月至2016年9月的溃疡形成和骨髓炎治疗含庆大霉素硫酸钙/羟基磷灰石骨移植物的数据替代糖尿病患者骨移植替代品，并评估。在该回顾性单臂壳体系列中共用了35名患者，并且连续跟踪至少一年或直至确认愈合。 199％的病变影响了Tarsus / Talus的远端行，十个钙羚和另外六个位于跖骨上。虽然所有跖骨病变在1年随访中愈合，但后脚区的愈合率较低，在钙盘下较低，分别在12个月内在远端Tarsus和Talus的72.2％。溃疡性骨感染的整体治愈率为81.3％。在两种性脑病变（25％）中，临床上需要两种远端牙桃蛋白疮/缩略图（11.1％）截肢。在涉及广泛的清创患者的多学科方法，涉及软组织溃疡的糖尿病足部感染治疗糖尿病足部感染，随后具有可再吸收的庆大霉素洗脱的骨移植替代品，涉及软组织溃疡的糖尿病足部感染。

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