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JCM
Special Issues
Updates on Diabetic Foot Osteomyelitis
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Updates on Diabetic Foot Osteomyelitis

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "General Surgery".

Deadline for manuscript submissions: 31 May 2024 | Viewed by 2324

Special Issue Editors

Prof. Dr. Francisco Javier Álvaro-Afonso

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Guest Editor
Diabetic Foot Unit, Clínica Universitaria de Podología, Facultad de Enfermería, Fisioterapia y Podología, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Universidad Complutense de Madrid, 28040 Madrid, Spain
Interests: pharmaceutical development; diabetic neuropathy; wound healing; biomechanics; wounds; orthotics; pharmaceutics; diabetic foot, diabetic foot infection, diabetic foot osteomyelitis
Prof. Dr. Esther García Morales

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Guest Editor
1. Diabetic Foot Unit, Clínica Universitaria de Podología, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain
2. Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
Interests: diabetic foot; diabetic foot ulcer; diabetic foot infection; diabetic foot osteomyelitis; diabetic neuropathy; biomechanics; wound healing
Prof. Dr. Yolanda García Álvarez

E-Mail Website
Guest Editor
1. Diabetic Foot Unit, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain
2. Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
Interests: diabetic foot; diabetic foot ulcer; diabetic foot infection; diabetic foot osteomyelitis; diabetic neuropathy; wound healing; biomechanics

Special Issue Information

Dear Colleagues,

Diabetic foot osteomyelitis (DFO) is the most frequent infection associated with diabetic foot ulcers, occurring in >20% of moderate infections and 50–60% of severe infections, and is associated with high rates of amputation. Currently, the diagnosis and management of DFO remains challenging. Any professional who manages DFO must bear in mind that it is a disease that has several clinical presentations, and therapy will be influenced mainly by the presence of both soft-tissue and necrotizing infections, vascular disease, and ulcer location. Nevertheless, today, DFO is related to late diagnosis, delayed referral, or ill-indicated treatment. Unfortunately, there are few high-quality clinical trials that stratify clinical presentations of DFO or compare different options of treatments in this type of infection.

The current Special Issue of JCM invites clinical researchers to contribute original research manuscripts and review articles that discuss some challenges regarding DFO diagnosis (the role of clinical inflammatory signs, probe-to-bone test, plain X-rays, MRI, laboratory tests) or treatment options (duration of medical treatment, medical treatment versus surgical treatment, choice of proper surgical treatment, or the role of adjuvant therapies).

We look forward to receiving your submission.

Prof. Dr. Francisco Javier Álvaro-Afonso
Prof. Dr. Esther García Morales
Prof. Dr. Yolanda García Álvarez
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • diabetic foot
  • diabetic foot ulcer
  • diabetic foot osteomyelitis
  • diabetic foot infections
  • diabetic foot treatment

Published Papers (2 papers)

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11 pages, 564 KiB  
Article
Analysis of the Influence of Diabetic Nephropathy in Patients with Diabetic Foot Osteomyelitis
by Yolanda García-Álvarez, Francisco Javier Álvaro-Afonso, Marta García-Madrid, Aroa Tardáguila-García, Mateo López-Moral and José Luis Lázaro-Martínez
J. Clin. Med. 2023, 12(17), 5557; https://doi.org/10.3390/jcm12175557 - 26 Aug 2023
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Abstract
This study analyzed the influence of diabetic nephropathy on the healing prognosis after conservative surgery in diabetic foot osteomyelitis (DFO). A retrospective observational study was carried out between January 2021 and December 2022 and involved 278 outpatients with a diagnosis of DFO at [...] Read more.
This study analyzed the influence of diabetic nephropathy on the healing prognosis after conservative surgery in diabetic foot osteomyelitis (DFO). A retrospective observational study was carried out between January 2021 and December 2022 and involved 278 outpatients with a diagnosis of DFO at a specialized diabetic foot unit, including 74 (26.62%) patients with DN (group 2) and 204 (73.38%) patients without DN (group 1). There were 266 (95.70%) ulcers on the forefoot, 8 (2.90%) on the midfoot, and 4 (1.45%) on the hindfoot (p = 0.992). The healing rates were 85.1% (n = 63) for group 2 and 81.3% (n = 165) for group 1 (p = 0.457). When exploring the influence of DN on the risk of delayed ulcer healing, the results did not show a significant effect [12 (6; 28) weeks among patients with DN vs. 12 (6; 21) weeks among patients without DN; p = 0.576]. No significant differences were observed in complications, with one (2.59%) death occurring in group 1 (p = 0.296) and three minor amputations being performed in both groups [two (5.13%) amputations in group 1 vs. one amputation (9.09%) in group 2; p = 0.217]. Bone cultures were performed for a total of 190 patients (133 in group 1 and 57 in group 2). Of these, 176 positive bone cultures were isolated: 71 positive bone cultures (57.7%) were monomicrobial cultures in group 1, with 30 (56.6%) in group 2. There were 52 (42.3%) that had at least two microorganisms in group 1, and 23 (43.4%) in group 2 (p = 0.890). The most frequently prescribed oral antibiotic was amoxicillin/clavulanate (43.89%), followed by levofloxacin (28.4%), and trimethoprim/sulfamethoxazole (14.7%). This study shows that DN does not have a significant influence on the healing prognosis of patients with DFO after conservative surgery. Full article
(This article belongs to the Special Issue Updates on Diabetic Foot Osteomyelitis)
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13 pages, 3606 KiB  
Systematic Review
Is the Combination of Plain X-ray and Probe-to-Bone Test Useful for Diagnosing Diabetic Foot Osteomyelitis? A Systematic Review and Meta-Analysis
by María del Mar Calvo-Wright, Francisco Javier Álvaro-Afonso, Mateo López-Moral, Yolanda García-Álvarez, Esther García-Morales and José Luis Lázaro-Martínez
J. Clin. Med. 2023, 12(16), 5369; https://doi.org/10.3390/jcm12165369 - 18 Aug 2023
Cited by 1 | Viewed by 1114
Abstract
A systematic review and meta-analysis was conducted to assess the diagnostic accuracy of the combination of plain X-ray and probe-to-bone (PTB) test for diagnosing diabetic foot osteomyelitis (DFO). This systematic review has been registered in PROSPERO (a prospective international register of systematic reviews; [...] Read more.
A systematic review and meta-analysis was conducted to assess the diagnostic accuracy of the combination of plain X-ray and probe-to-bone (PTB) test for diagnosing diabetic foot osteomyelitis (DFO). This systematic review has been registered in PROSPERO (a prospective international register of systematic reviews; identification code CRD42023436757). A literature search was conducted for each test separately along with a third search for their combination. A total of 18 articles were found and divided into three groups for separate analysis and comparison. All selected studies were evaluated using STROBE guidelines to assess the quality of reporting for observational studies. Meta-DiSc software was used to analyze the collected data. Concerning the diagnostic accuracy variables for each case, the pooled sensitivity (SEN) was higher for the combination of PTB and plain X-ray [0.94 (PTB + X-ray) vs. 0.91 (PTB) vs. 0.76 (X-ray)], as was the diagnostic odds ratio (DOR) (82.212 (PTB + X-ray) vs. 57.444 (PTB) vs. 4.897 (X-ray)). The specificity (SPE) and positive likelihood ratio (LR+) were equally satisfactory for the diagnostic combination but somewhat lower than for PTB alone (SPE: 0.83 (PTB + X-ray) vs. 0.86 (PTB) vs. 0.76 (X-ray); LR+: 5.684 (PTB + X-ray) vs. 6.344 (PTB) vs. 1.969 (X-ray)). The combination of PTB and plain X-ray showed high diagnostic accuracy comparable to that of MRI and histopathology diagnosis (the gold standard), so it could be considered useful for the diagnosis of DFO. In addition, this diagnostic combination is accessible and inexpensive but requires training and experience to correctly interpret the results. Therefore, recommendations for this technique should be included in the context of specialized units with a high prevalence of DFO. Full article
(This article belongs to the Special Issue Updates on Diabetic Foot Osteomyelitis)
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