J Bone Jt Infect 2020; 5(4):198-204. doi:10.7150/jbji.45338

Review

Surgical techniques for Bone Biopsy in Diabetic Foot Infection, and association between results and treatment duration

Senneville Eric1,2✉, Joulie Donatienne2,3, Blondiaux Nicolas2,4, Robineau Olivier1,2

1. Infectious Diseases Department Gustave Dron Hospital F-59200 Tourcoing, and Lille University F-59000, Lille, France.
2. Northern-West French National Referent Centre for Complex Bone and Joint Infections (CRIOAC Lille-Tourcoing).
3. Orthopaedic Surgery Department G. Dron Hospital Tourcoing F-59200 Tourcoing France.
4. Microbiology Laboratory G. Dron Hospital Tourcoing F-59200 Tourcoing France.

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Citation:
Eric S, Donatienne J, Nicolas B, Olivier R. Surgical techniques for Bone Biopsy in Diabetic Foot Infection, and association between results and treatment duration. J Bone Jt Infect 2020; 5(4):198-204. doi:10.7150/jbji.45338. Available from http://www.jbji.net/v05p0198.htm

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Abstract

Surgery is an important part of the management of patients diagnosed with DFO. It consists in some selected patients, to remove all or part of the infected bone(s) or even to amputate all or part of the foot. Despite the use of sophisticated imaging techniques, it is however difficult to remove all the infected tissue while respecting the principles of an economical surgery. Bone biopsy performed at the margins of the resection permits to identify residual osteomyelitis and to adjust the post-surgical antibiotic treatment. Some recent studies have reported the way to perform bone margin biopsies and have assessed the impact of the bone results on the patient's outcome. However, the real impact of a residual osteomyelitis on the risk of recurrent DFO is still debated and questions regarding the interpretation of the results remain to be solved. Similarly, the consequences in terms of choice and duration of the antimicrobial treatment to use in case of positive bone margin are not clearly established.

Keywords: diabetic foot osteomyelitis, bone margins biopsy, outcome, antibiotic therapy, surgery