Infected puncture wounds in adults with diabetes: Risk factors for osteomyelitis

L. A. Lavery, L. B. Harkless, H. R. Ashry, K. Felder-Johnson

Research output: Contribution to journalArticle

22 Scopus citations

Abstract

The purpose of this study was to investigate factors that contribute to the development of osteomyelitis of the foot after a puncture wound in patients with diabetes. Forty-five male and 21 female adults with diabetes that were admitted to the hospital for a foot infection precipitated by a puncture were included in the study. Twenty-two (33%) patients had osteomyelitis (O) based on either a positive bone culture or pathology report. Forty-four patients had soft tissue infections (ST). Age and duration of diabetes were similar in both groups. Patients with osteomyelitis received medical treatment later than patients with soft tissue infections. A significant difference was identified when comparing the time interval from the time of the injury until patients were hospitalized and until they had the puncture wound surgically debrided, and when comparing the interval from when patients first received initial professional medical evaluation until they were hospitalized and until they had the puncture wound surgically debrided. Patients with punctures involving the forefoot (FF) and patients that wore shoes (S) at the time of the injury were more likely to develop osteomyelitis than patients that had rearfoot (RF) injuries (O: FF = 20, 90%, RF = 2, 10%, ST: FF = 30, 70%, RF = 13, 30%, p < 0.05) and patients that were barefoot (B) at the time of the injury (O: S = 15, 88%, B = 2, 12%, ST: S = 21, 57%, B = 16, 43%, p < 0.05). Osteomyelitis is a common complication in patients with diabetes with a foot infection following a puncture wound. This data suggests that developing osteomyelitis is associated with the location of the injury, delay in receiving medical treatment, and whether footwear was worn at the time of the injury.

Original languageEnglish (US)
Pages (from-to)561-566
Number of pages6
JournalJournal of Foot and Ankle Surgery
Volume33
Issue number6
StatePublished - Dec 1 1994

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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