Gerardo Víquez-Molina, Javier Aragón-Sánchez, María Eugenia López-Valverde, Javier Aragón-Hernández, Cristina Aragón-Hernández, José María Rojas-Bonilla
{"title":"Differences in Foot Infections Secondary to Puncture Wounds or Chronic Ulcers in Diabetes.","authors":"Gerardo Víquez-Molina, Javier Aragón-Sánchez, María Eugenia López-Valverde, Javier Aragón-Hernández, Cristina Aragón-Hernández, José María Rojas-Bonilla","doi":"10.1177/15347346231207437","DOIUrl":null,"url":null,"abstract":"<p><p>We hypothesized that foot infections secondary to a puncture wounds (PWs) have a worse prognosis concerning infection-related mortality, recurrence of the infection, and healing than those secondary to a chronic ulcer. We conducted a prospective study consisting of 200 patients with moderate-to-severe diabetic foot infections. The cohort consisted of 155 men (77.5%) and 45 women (22.5%). The mean age of the patients was 59 years (standard deviation 12.2). Puncture wounds were the cause of the infection in 107 patients (53.5%) and a chronic ulcer was the cause in 93 patients (46.5%). One hundred and eleven patients (55.5%) had moderate and 89 (44.5%) had severe infections. Osteomyelitis was more frequently found in chronic ulcers (71%) than in PWs (44.9%), <i>P</i> < .001. Cox's survival analysis using PWs as an explanatory variable showed no association with infection-related mortality (hazard ratio [HR] 1.06, 95% confidence interval [CI] 0.32-3.46, <i>P</i> = .92), time to recurrence of infection (HR 0.64, 95% CI 0.27-1.51, <i>P</i> = .30), and time to healing (HR 0.81, 95% CI 0.60-1.08, <i>P</i> = .15). More than half of our patients had PWs as the mechanism by which the infection occurred. These patients usually had a lower rate of osteomyelitis but required hospitalization and antibiotic therapy more frequently than patients with infected chronic ulcers. We found no difference in outcomes between the 2 groups.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"The international journal of lower extremity wounds","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/15347346231207437","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
We hypothesized that foot infections secondary to a puncture wounds (PWs) have a worse prognosis concerning infection-related mortality, recurrence of the infection, and healing than those secondary to a chronic ulcer. We conducted a prospective study consisting of 200 patients with moderate-to-severe diabetic foot infections. The cohort consisted of 155 men (77.5%) and 45 women (22.5%). The mean age of the patients was 59 years (standard deviation 12.2). Puncture wounds were the cause of the infection in 107 patients (53.5%) and a chronic ulcer was the cause in 93 patients (46.5%). One hundred and eleven patients (55.5%) had moderate and 89 (44.5%) had severe infections. Osteomyelitis was more frequently found in chronic ulcers (71%) than in PWs (44.9%), P < .001. Cox's survival analysis using PWs as an explanatory variable showed no association with infection-related mortality (hazard ratio [HR] 1.06, 95% confidence interval [CI] 0.32-3.46, P = .92), time to recurrence of infection (HR 0.64, 95% CI 0.27-1.51, P = .30), and time to healing (HR 0.81, 95% CI 0.60-1.08, P = .15). More than half of our patients had PWs as the mechanism by which the infection occurred. These patients usually had a lower rate of osteomyelitis but required hospitalization and antibiotic therapy more frequently than patients with infected chronic ulcers. We found no difference in outcomes between the 2 groups.