Could Soft Tissue Infection Influence the Outcomes of Diabetic Foot Osteomyelitis? Data from a Retrospective Study

Area of Science:

• Podiatry
• Infectious Diseases
• Diabetology

Background:

• Diabetic foot osteomyelitis (DFO) is a severe complication of diabetes, often associated with soft tissue infections (STI).
• Forefoot DFO requires effective management strategies to prevent adverse outcomes.

Purpose of the Study:

• To compare the outcomes of patients with diabetic foot osteomyelitis (DFO) and concomitant soft tissue infection (STI) versus those with DFO alone.
• To identify predictors of non-healing in patients with forefoot DFO.

Main Methods:

• Retrospective observational study of 166 patients with forefoot DFO from 2019-2022.
• Patients were divided into two groups: DFO with STI (n=114) and DFO without STI (n=52).
• Conservative surgical debridement of infected bone and antibiotic therapy were administered to all patients, followed by 1-year follow-up.

Main Results:

• Patients with DFO and STI had significantly lower healing rates (52.3% vs. 94.2%, p=0.005) and longer healing times (7.8 vs. 4.6 weeks, p=0.0002).
• The DFO with STI group experienced higher rates of minor amputation (13.1% vs. 3.8%, p=0.04) and hospitalization (66.7% vs. 48.1%, p<0.002).
• Soft tissue infection (STI) was an independent predictor of non-healing (OR 3.1, p=0.002).

Conclusions:

• Concomitant soft tissue infection significantly worsens outcomes for patients with diabetic foot osteomyelitis.
• Early identification and management of soft tissue infections are crucial for improving healing rates and reducing amputation risk in DFO patients.
• Soft tissue infection is a key factor associated with non-healing in forefoot DFO.