ABSTRACT
The aim of this pilot study was to determine clinical and laboratory factors that predict amputation surgery and to evaluate the predictive value of soluble CD14 [sCD14], interleukin-6 [IL-6], and procalcitonin [PCT] in patients with diabetic foot ulcers [DFUs]. Twenty-seven [20 males, 7 females] Diabetic Foot Ulcers [DFU] patients admitted to our department were consecutively enrolled. The patients' demographics and wound characteristics were noted. IL-6, PCT, and sCD14 were measured at admission. Six of the 27 patients [22%] eventually underwent lower extremity amputation. Compared to the non-amputation group, a previous history of amputation [p=0.017], the presence of gangrene [p=0.044], the Wagner grade [p=0.011], the IL-6 concentration [p=0.018], the white blood cell count [WBC] [p=0.036], and the erythrocyte sedimentation rate [ESR] [p=0.042] were significantly high in the amputation group. However, the sCOf4 and PCT concentration were not significantly different. We have shown for the first time that IL-6 may have predictive value for lower extremity amputation in patients with DFU. Further studies are needed to confirm its predictive value in this patient group
ABSTRACT
The treatment of diabetic foot osteomyelitis [DFO] is a controversial issue, with disagreement regarding whether the best treatment is surgical or conservative. The purpose of this study was to compare the outcome of patients with DFO who were treated with antibiotherapy alone and those who underwent concurrent minor amputation. Hospital records of patients who were diagnosed as having DFO within a 2-year study period were retrospectively reviewed. Patients were divided into two groups: those who received antibiotherapy alone and those who underwent concurrent minor amputation. Groups were compared in terms of duration in hospitalization, antibiotherapy, and wound healing. Thirty seven patients were included in the study. These comprised patients who received antibiotherapy alone [ABG, n=15] and patients who underwent concurrent minor amputation [AB-MAG, n=22]. Hospitalization duration was 37.2 [+/- 16.2] days in ABG and 52.8 [+/- 40.2] days in AB-MAG [p = 0.166]. Mean duration of antibiotherapy was 45.0 [+/- 21.7] days in ABG and 47.7 [+/- 19] days in AB-MAG [p = 0.689]. Wound healing duration was 265.2 [+/- 132.7] days in ABG and 222.6 [+/- 85.9] days in AB-MAG [p = 0.243]. None of the outcome measures were significantly different between ABG and AB-MAG. Our results have shown similar outcomes for both patient groups who received antibiotherapy alone and who underwent concurrent minor amputations. Considering the small sample sizes in this study, it is important to confirm these results on a larger scale