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Maximally Disfiguring Surgery for Forefoot Osteomyelitis: Time for a Rethink?
Han Jie Lee1, Ken Min Chin1, Shaun Lee2
1Department of General Surgery, Singapore General Hospital, Singapore.
Surgical treatment for diabetic foot osteomyelitis often involves extensive amputation. This study presents cases where bone infection was removed while preserving soft tissues, achieving good outcomes and questioning current practices.
Area of Science:
- Orthopedics
- Infectious Diseases
- Vascular Surgery
Background:
- Diabetic foot osteomyelitis (DFO) treatment typically involves surgical debridement and antibiotics.
- Current dogma mandates aggressive bone and soft tissue resection for source control, often leading to significant morbidity.
Observation:
- Two cases of forefoot osteomyelitis were treated with complete bony resection but preservation of the soft tissue envelope.
- These patients experienced favorable outcomes following the less invasive surgical approach.
Findings:
- Complete bony resection of osteomyelitis with soft tissue sparing can yield good clinical results.
- This approach challenges the necessity of maximal soft tissue debridement alongside bone resection in DFO.
Implications:
- Minimally invasive surgical techniques may offer an alternative for DFO treatment, reducing negative impacts on foot biomechanics and patient well-being.
- Further research is warranted to validate soft tissue-sparing debridement in DFO management and its long-term efficacy.
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