title: Primary closure of infected diabetic foot wounds. A report of closed instillation in 30 cases.
abstract: Multiple surgical strategies are available for managing the infected diabetic foot at risk for amputation. The authors present their experience with the closed instillation system in the management of 30 such cases in 29 patients over a 5-year period. Data were collected from the hospital records of neuropathic patients presenting with deep-plantar-space infections or presumed acute osteomyelitis. All 29 patients were male; 57% had marginal or poor vascular supply, and 83% were nutritionally compromised or had proteinuria. At the conclusion of the study, 34% of the patients were dead, reflecting the severity of comorbid conditions found in this population. Despite the marginal healing capacity of these patients, the procedure had a 90% success rate, as defined by expeditious return to prior level of functioning and residential living situation without need for re-operation or higher-level amputation.
authors.affiliation: Department of Surgery (Podiatry), Dartmouth Medical School, Hanover, NH, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Connolly
authors.forename: J S
authors.initials: JS
authors.lastname: Wrobel
authors.forename: R F
authors.initials: RF
authors.lastname: Anderson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015897:Comorbidity; D017719:Diabetic Foot / Q000150:complications*; D004322:Drainage / Q000379:methods*; D005839:Gentamicins / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009748:Nutrition Disorders / Q000150:complications; D010019:Osteomyelitis / Q000209:etiology* / Q000601:surgery*; D011507:Proteinuria / Q000150:complications; D012189:Retrospective Studies; D013536:Suture Techniques; D007507:Therapeutic Irrigation / Q000379:methods*; D016896:Treatment Outcome; D014945:Wound Healing; D014946:Wound Infection / Q000209:etiology* / Q000601:surgery*
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins