Diabetic patients are at increased risk of developing
foot ulcers which may cause bone
infections associated with a high probability of both
amputation and mortality. Therefore, prompt diagnosis and adequate treatment are of key importance. In our
Diabetic Foot Unit, effective multidisciplinary treatment of
osteomyelitis secondary to diabetes involves the application of a
gentamicin-eluting
calcium sulphate/
hydroxyapatite bone graft substitute to fill residual bone voids after
debridement. The data of all patients treated with the
gentamicin-eluting
calcium sulphate/
hydroxyapatite bone graft substitute for
diabetic foot infections with
ulcer formation and
osteomyelitis at metatarsals, calcaneus and hindfoot at our institute from July 2013 to September 2016 were retrospectively collected and evaluated. A total of 35 patients were included in this retrospective single-arm case series and were either continuously followed up for at least one year or until healing was confirmed. Nineteen lesions affected the distal row of tarsus/talus, ten the calcaneus and a further six were located at the metatarsals. While all of the metatarsal lesions had healed at 1-year follow-up, the healing rate in the hindfoot region was lower with 62.5% at the calcaneus and 72.2% at the distal tarsus and talus at 12 months, respectively. The overall cure rate for ulcerous bone
infection was 81.3%. In two calcaneal lesions (25%) and two lesions of distal tarsus/talus (11.1%)
amputation was considered clinically necessary. Promising results were achieved in the treatment of
diabetic foot infections with soft tissue
ulcers by a multidisciplinary approach involving extensive
debridement followed by adequate dead space management with a resorbable
gentamicin-eluting bone graft substitute.