CAN AGGRESSIVE TREATMENT OF DIABETIC FOOT INFECTIONS REDUCE THE NEED FOR ABOVE-ANKLE AMPUTATION

We retrospectively evaluated the charts of 112 patients with diabetic foot infection to determine if early aggressive surgical intervention improves outcome. All patients were classified into two groups on the basis of the timing of surgical intervention and appropriate antimicro bial therapy. Group I included patients who underwent no surgical inte rvention during the first 3 days of hospitalization but received intra venous antimicrobial therapy, and group II included patients who under went surgical intervention promptly and received intravenous antimicro bial therapy. Group II was further divided; group IIA included patient s who underwent debridement, and group IIB included patients who under went local limited amputation. A higher rate of patients in group I th an in group II (27.6% vs. 13%, respectively; P < .01) required above-a nkle amputation during the same hospitalization or subsequent admissio n. Overall, an aggressive surgical approach against foot infection in hospitalized diabetic patients reduced the need for above-ankle amputa tion and the length of hospital stay by at least 6 days. Treatment of diabetic foot infection requires the combination of early surgical tre atment and antimicrobial therapy.