Primary closure of infected diabetic foot wounds - A report of closed instillation in 30 cases

Multiple surgical strategies are available for managing the infected diabet ic foot at risk for amputation. The authors present their experience with t he closed instillation system in the management of 30 such cases in 29 pati ents over a 5-year period. Data were collected from the hospital records of neuropathic patients presenting with deep-plantar-space infections or pres umed acute osteomyelitis. All 29 patients were male; 57% had marginal or po or vascular supply, and 83% were nutritionally compromised or had proteinur ia. At the conclusion of the study, 34% of the patients were dead, reflecti ng the severity of comorbid conditions found in this population. Despite th e marginal healing capacity of these patients, the procedure had a 90% succ ess rate, as defined by expeditious return to prior level of functioning an d residential living situation without need for re-operation or higher-leve l amputation.