Article ; Online: Reliability and Safety of Bedside Blind Bone Biopsy Performed by a Diabetologist for the Diagnosis and Treatment of Diabetic Foot Osteomyelitis.
2021 Volume 44, Issue 11, Page(s) 2480–2486
Abstract: Objective: Bone biopsy (BB) performed by a surgeon or an interventional radiologist is recommended for suspicion of osteomyelitis underlying diabetic foot ulcer (DFU). To facilitate its practice, we developed a procedure allowing bedside blind bone ... ...
| Abstract | Objective: Bone biopsy (BB) performed by a surgeon or an interventional radiologist is recommended for suspicion of osteomyelitis underlying diabetic foot ulcer (DFU). To facilitate its practice, we developed a procedure allowing bedside blind bone biopsy (B4) by a diabetologist. Research design and methods: We conducted a three-step observational study consisting of a feasibility and safety phase (phase 1) to assess the success and side effects of B4, a validity phase (phase 2) to compare DFU outcomes between positive (B4+) and negative (B4-) bone cultures, and a performance phase (phase 3) to compare B4 with the conventional surgical or radiological procedure basic bone biopsy (B3). Primary end points were the presence of bone tissue (phase 1) and complete DFU healing with exclusive medical treatment at 12 months (phases 2 and 3). Results: In phase 1, 37 consecutive patients with clinical and/or radiological suspicion of DFU osteomyelitis underwent B4. Bone tissue was collected in all patients with few side effects. In phase 2, a B4+ bone culture was found in 40 of 79 (50.6%) participants. Among B4+ patients, complete wound healing after treatment was 57.5%. No statistical difference was observed with patients with B4- bone culture not treated with antibiotics (71.8%, Conclusions: B4 is a simple, safe, and efficient procedure for the diagnosis of DFU osteomyelitis with a similar proportion of healing to conventional BB. |
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| MeSH term(s) | Biopsy/methods ; Bone and Bones/pathology ; Diabetes Mellitus ; Diabetic Foot/diagnosis ; Humans ; Osteomyelitis/diagnosis ; Osteomyelitis/drug therapy ; Reproducibility of Results | ||||||||||
| Language | English | ||||||||||
| Publishing date | 2021-09-02 | ||||||||||
| Publishing country | United States | ||||||||||
| Document type | Journal Article ; Observational Study | ||||||||||
| ZDB-ID | 441231-x | ||||||||||
| ISSN | 1935-5548 ; 0149-5992 | ||||||||||
| ISSN (online) | 1935-5548 | ||||||||||
| ISSN | 0149-5992 | ||||||||||
| DOI | 10.2337/dc20-3170 | ||||||||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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