Articles | Volume 10, issue 3
https://doi.org/10.5194/jbji-10-199-2025
https://doi.org/10.5194/jbji-10-199-2025
Original full-length article
 | 
16 Jun 2025
Original full-length article |  | 16 Jun 2025

CLOSE-UP – a favourable protocol for limb-sparing surgery of diabetic foot osteomyelitis

Anton Alexander Nolte Peterlin, Louise Kruse Jensen, Emil Gleipner-Andersen, and Hans Gottlieb

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Subject: Osteomyelitis | Topic: Surgery
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Cited articles

Aragón-Sánchez, F. J., Cabrera-Galván, J. J., Quintana-Marrero, Y., Hernández-Herrero, M. J., Lázaro-Martínez, J. L., García-Morales, E., Beneit-Montesinos, J. V., and Armstrong, D. G.: Outcomes of surgical treatment of diabetic foot osteomyelitis: A series of 185 patients with histopathological confirmation of bone involvement, Diabetologia, 51, 1962–1970, https://doi.org/10.1007/s00125-008-1131-8, 2008. 
Aragón-Sánchez, J. and Lipsky, B. A.: Modern management of diabetic foot osteomyelitis. The when, how and why of conservative approaches, Expert Rev. Anti-Infe., 16, 35–50, https://doi.org/10.1080/14787210.2018.1417037, 2 January 2018. 
Aragón-Sánchez, J., Víquez-Molina, G., López-Valverde, M. E., Rojas-Bonilla, J. M., and Murillo-Vargas, C.: Conservative Surgery for Diabetic Foot Osteomyelitis is not Associated With Longer Survival Time Without Recurrence of Foot Ulcer When Compared With Amputation, Int. J. Low Extrem. Wounds, 22, 328–331, https://doi.org/10.1177/15347346211009403, 1 June 2023. 
Baek, Y. J., Lee, E., Jung, J., Won, S. H., An, C. Y., Kang, E. M., Park, S. Y., Baek, S. L., Chun, D. Il, and Kim, T. H.: Diabetic Foot Osteomyelitis Undergoing Amputation: Epidemiology and Prognostic Factors for Treatment Failure, Open Forum Infect. Dis., 11, 1–7, https://doi.org/10.1093/ofid/ofae236, 2024. 
Blanchette, V., Houde, L., Armstrong, D. G., and Schmidt, B. M.: Outcomes of Hallux Amputation Versus Partial First Ray Resection in People with Non-Healing Diabetic Foot Ulcers: A Pragmatic Observational Cohort Study, Int. J. Low. Extr. Wound., 24, 225–234, https://doi.org/10.1177/15347346221122859, 2022. 
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Short summary
Diabetic foot osteomyelitis is a severe diabetes complication that increases the risk of limb loss and death. This study assessed a one-stage surgical approach with primary wound closure and local antibiotics, showing favourable results. Among 97 patients, 13 needed further treatment, but only 4 required major amputation. Poor circulation was the main factor in failure. These findings challenge traditional methods and may improve quality of life, although further high-quality trials are needed.
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