Residual osteomyelitis at the resection margin after conservative surgery is not associated with the recurrence of diabetic foot infection and may successfully be treated without postoperative antibiotic therapy
Authors' conclusion
A positive margin was neither associated with the recurrence of the infection nor with the time to healing. More than half of patients with pathology-confirmed positive margins were treated without postoperative antibiotics and this approach was not associated with the recurrence of the infection.
Study context
- Population
- Patients with histopathology-confirmed diabetes-related foot osteomyelitis undergoing bone resection, with additional bone biopsy at the resection margin
- Participants
- 93 patients
- Exposure
- Pathology- or microbiology-confirmed positive vs negative bone resection margins
- Pathology-confirmed positive marginsn = 62
- Outcome
- Recurrence of the infection
Main finding
As reported in the abstract
Recurrence of infection
Recurrence overall
19 patients
20.4%
Observational data: associations, not effects.
Further findings
| Outcome | Pathology-confirmed positive margins | Pathology-confirmed negative margins | P value |
|---|---|---|---|
| Time to healing | median 12 (CI 9.2–18) weeks | 14.9 (CI 10.2–21.9) weeks | Log-rank test, p = 0.74 |
Positive margin prevalence
Cases
- Pathology-confirmed positive margins
- 62 (66.7%)
- Microbiology-confirmed positive margins
- 75 (80.6%)
Pathology-confirmed positive margins: treatment without postoperative antibiotics and recurrence
- Treated without postoperative antibiotics (of 61 available for follow-up)
- 34 (55.7%)
- No association of recurrence with postoperative antibiotic use (p = 0.47)
Original publication
Residual osteomyelitis at the resection margin after conservative surgery is not associated with the recurrence of diabetic foot infection and may successfully be treated without postoperative antibiotic therapy. Diabet Med. Published 18 June 2023. doi:10.
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