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Volume 12 Issue 2 ( April- June) 2023

Original Articles

Below-knee amputation under spinal anesthesia for osteomyelitis of the diabetic foot: Assessment of histopathology, microbial infection, and management
Dr. Balendra Singh Sodhi, Dr. (Lt Col) Shoba Srinivasan, Dr. Vijay Kumar Sharma, Dr. Hiren Vipinchandra Shah

Amputation may result from a common complication known as diabetic foot infection. Osteomyelitis outside of the context of the diabetic foot has a poor prognosis when it is present at the histopathologic margin of resection. In the prospective study design, we sought to evaluate clinical complications, healing, and microbiological evaluation of osteolyelitic and related amputations in patients with diabetes. We evaluated the frequency of amputation, the length of hospitalization, the causative organism's microbial culture, and histological parameters. Out of 18 patients, 12 had below-knee-above-ankle (major) amputations, and 6 had below-ankle (minor) amputations. The average age of the amputee patients was approximately 67.2 years. The length of hospitalization was longer in cases of major amputations. The pattern of microbial growth was similar in major vs. minor amputation osteomyelitis, and a similar range of microorganisms was reported in swabs, soft tissue, and bone cultures. Evaluation of osteomyelitis may help in planning for amputaions, which require the assessment of associated complications and related biochemical and histological parameters. We suggest that critical pathological evaluation of osteomyelitis may help in the determination of an antibiotic regimen post-amputation.

 
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