Bioactive glass, a new tool for the treatment in the diabetic foot recalcitrant osteomyelitis: A case series with 24-month follow-up
•The bioactive glass is a new promising tool in patients with diabetic foot osteomyelitis.•The bioactive glass allows to eradicate the infection preserving the limb.•None of the treated patients showed signs of persistent infection at the end of the follow-up.•The main complications in the treatment...
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Published in | Foot (Edinburgh, Scotland) Vol. 48; p. 101831 |
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Format | Journal Article |
Language | English |
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01.09.2021
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Abstract | •The bioactive glass is a new promising tool in patients with diabetic foot osteomyelitis.•The bioactive glass allows to eradicate the infection preserving the limb.•None of the treated patients showed signs of persistent infection at the end of the follow-up.•The main complications in the treatment with BAG are due to vascularization and skin coverage issues.•A strict patient selection is mandatory to achieve success.
The bioactive glass (BAG) is a promising solution for the reconstruction of bone defects and the eradication of infection in patients with osteomyelitis, however references to the treatment of diabetic foot osteomyelitis are scarce in the literature.
Our experience in patients with diabetic foot osteomyelitis, who required surgical debridement and void filling, in which we use bioactive glass (n = 6), was evaluated. During a minimum follow-up of 24 months, the presence of persistent infection and healing rate, post-surgical complications, surgical reinterventions, degree of osseointegration and BAG-related side effects was analyzed.
At the end of the follow-up, none of the patients showed signs of persistent infection and the healing rate was 66.6% (4/6).
Postoperative complications were noted in 3 patients and two of the them required new surgical intervention, both due to skin coverage or vascular complications.
A complete osseointegration in the 66.6% of the patients and no cases of local adverse effects were recorded.
The bioactive glass can be a useful tool in the treatment of certain cases of diabetic foot osteomyelitis, provided that a multidisciplinary approach and strict patient selection is in place.
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AbstractList | •The bioactive glass is a new promising tool in patients with diabetic foot osteomyelitis.•The bioactive glass allows to eradicate the infection preserving the limb.•None of the treated patients showed signs of persistent infection at the end of the follow-up.•The main complications in the treatment with BAG are due to vascularization and skin coverage issues.•A strict patient selection is mandatory to achieve success.
The bioactive glass (BAG) is a promising solution for the reconstruction of bone defects and the eradication of infection in patients with osteomyelitis, however references to the treatment of diabetic foot osteomyelitis are scarce in the literature.
Our experience in patients with diabetic foot osteomyelitis, who required surgical debridement and void filling, in which we use bioactive glass (n = 6), was evaluated. During a minimum follow-up of 24 months, the presence of persistent infection and healing rate, post-surgical complications, surgical reinterventions, degree of osseointegration and BAG-related side effects was analyzed.
At the end of the follow-up, none of the patients showed signs of persistent infection and the healing rate was 66.6% (4/6).
Postoperative complications were noted in 3 patients and two of the them required new surgical intervention, both due to skin coverage or vascular complications.
A complete osseointegration in the 66.6% of the patients and no cases of local adverse effects were recorded.
The bioactive glass can be a useful tool in the treatment of certain cases of diabetic foot osteomyelitis, provided that a multidisciplinary approach and strict patient selection is in place.
IV. BACKGROUNDThe bioactive glass (BAG) is a promising solution for the reconstruction of bone defects and the eradication of infection in patients with osteomyelitis, however references to the treatment of diabetic foot osteomyelitis are scarce in the literature. METHODSOur experience in patients with diabetic foot osteomyelitis, who required surgical debridement and void filling, in which we use bioactive glass (n = 6), was evaluated. During a minimum follow-up of 24 months, the presence of persistent infection and healing rate, post-surgical complications, surgical reinterventions, degree of osseointegration and BAG-related side effects was analyzed. RESULTSAt the end of the follow-up, none of the patients showed signs of persistent infection and the healing rate was 66.6% (4/6). Postoperative complications were noted in 3 patients and two of the them required new surgical intervention, both due to skin coverage or vascular complications. A complete osseointegration in the 66.6% of the patients and no cases of local adverse effects were recorded. CONCLUSIONSThe bioactive glass can be a useful tool in the treatment of certain cases of diabetic foot osteomyelitis, provided that a multidisciplinary approach and strict patient selection is in place. LEVEL OF EVIDENCEIV. |
ArticleNumber | 101831 |
Author | Cuervas-Mons, Manuel Rodríguez, Ángel Parra, Guillermo |
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publication-title: J Antimicrob Chemother doi: 10.1093/jac/dkv327 contributor: fullname: Bortolin – start-page: 7 year: 2003 ident: 10.1016/j.foot.2021.101831_bib0095 article-title: A clinical staging system for adult osteomyelitis publication-title: Clin Orthop Relat Res doi: 10.1097/01.blo.0000088564.81746.62 contributor: fullname: Cierny – volume: 11 start-page: 1 year: 2018 ident: 10.1016/j.foot.2021.101831_bib0040 article-title: Recent evidence on bioactive glass antimicrobial and antibiofilm activity: a mini-review publication-title: Materials doi: 10.3390/ma11020326 contributor: fullname: Drago – volume: 36 year: 2020 ident: 10.1016/j.foot.2021.101831_bib0090 article-title: Guidelines on the diagnosis and treatment of foot infection in persons with diabetes (IWGDF 2019 update) publication-title: Diabetes Metab Res Rev doi: 10.1002/dmrr.3280 contributor: fullname: Lipsky – ident: 10.1016/j.foot.2021.101831_bib0010 – volume: 28 start-page: S14 year: 2019 ident: 10.1016/j.foot.2021.101831_bib0110 article-title: The use of bioactive glass S53P4 in the treatment of an infected Charcot foot: a case report publication-title: J Wound Care doi: 10.12968/jowc.2019.28.Sup1.S14 contributor: fullname: Godoy-Santos – volume: 105 start-page: 248 year: 2016 ident: 10.1016/j.foot.2021.101831_bib0080 article-title: Reconstruction of vertebral bone defects using an expandable replacement device and bioactive glass S53P4 in the treatment of vertebral osteomyelitis: three patients and three pathogens publication-title: Scand J Surg doi: 10.1177/1457496915626834 contributor: fullname: Kankare – volume: vol. 971 start-page: 81 year: 2017 ident: 10.1016/j.foot.2021.101831_bib0025 article-title: Antibacterial bioactive glass S53P4 for chronic bone infections – a multinational study contributor: fullname: Lindfors – volume: 13 start-page: 525 year: 2018 ident: 10.1016/j.foot.2021.101831_bib0030 article-title: BAG-S53P4 as bone graft extender and antimicrobial activity against gentamicin- and vancomycin-resistant bacteria publication-title: Future Microbiol doi: 10.2217/fmb-2016-0171 contributor: fullname: Bortolin – volume: 2 start-page: 194 year: 2017 ident: 10.1016/j.foot.2021.101831_bib0100 article-title: Treatment of cavitary bone defects in chronic osteomyelitis: bioactive glass S53P4 vs. calcium sulphate antibiotic beads publication-title: J Bone Jt Infect doi: 10.7150/jbji.20404 contributor: fullname: Ferrando – volume: 16 start-page: 35 year: 2018 ident: 10.1016/j.foot.2021.101831_bib0120 article-title: Modern management of diabetic foot osteomyelitis. The when, how and why of conservative approaches publication-title: Expert Rev Anti Infect Ther doi: 10.1080/14787210.2018.1417037 contributor: fullname: Aragón-Sánchez – start-page: 2275 year: 2012 ident: 10.1016/j.foot.2021.101831_bib0015 – volume: 10 start-page: 1293 year: 2015 ident: 10.1016/j.foot.2021.101831_bib0065 article-title: Antimicrobial activity and resistance selection of different bioglass S53P4 formulations against multidrug resistant strains publication-title: Future Microbiol doi: 10.2217/FMB.15.57 contributor: fullname: Drago |
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Title | Bioactive glass, a new tool for the treatment in the diabetic foot recalcitrant osteomyelitis: A case series with 24-month follow-up |
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