1145_Jacobs.pdf

1、NON-SURGICAL vs.SURGICAL TREATMENT OF OSTEOMYELITISALLEN MARK JACOBS DPM,FACFASI HAVE NO CONFLICT OF INTEREST FOR THIS DISCUSSIONON MAKING A DIAGNOSIS“MEDICINE IS A SCIENCE OF UNCERTAINTY AND AN ART OF PROBABILITY”THE PRACTICAL ISSUECURE OF OSTEOMYELITISVS.BIOMECHANICAL EFFECTS OF BONE RESECTION/AMP

2、UTATIONPLANTAR ULCERATION WITH CAVUS FOOT,DIABETES,NEUROPATHYTRANSFER ULCERATIONTHE PROBLEM OF TRANSFER ULCERATIONULCERATED CALLUSDIGITAL AMPUTATIONSFREQUENTLY ULCERATED HAMMER TOE,MALLET TOEADJACENT TOE TRANSFER ULCERATION IS NOT UNCOMMONHALLUX VALGUS WITH LOSS OF 2NDTOELOSS OF GREAT TOE ASSOCIATED

3、 WITH SECOND TOE,2ND,3RDMETATARSAL TRANSFER ULCERATIONPARTIAL 1STRAY AMPUTATIONS48 PATIENTS/50 PARTIAL 1STRAY AMPS24 REQUIRED FURTHER SURGERY12 REVISIONS TO TMA(AVG 282 DAYS)48%DID NOT REQUIRE REVISION“PARTIAL FIRST-RAY RESECTIONS ARE NOT HIGHLY SUCCESSFUL”PARTIAL FIRST-RAY AMPUTATIONS CAN BE A GOOD

4、 INITIAL PROCEDURE TO SALVAGE THE FOOT AND PROLONG A PATIENTS BIPEDAL AMBULATORY STATUS,THEREDBY LOWERING THE PATIENTS MORBIDITY AND MORTALITY”KADUKAMMAKAL,J.,YAU,S.,URBAS,W JAPMA 102(5)20121STRAY AMPUTATION REVISIONSADDITIONAL DIGIT 37.2%TMA 32.6%LIS FRANC 1.2%TRANSTIBIAL 29.1%BOROSKY,S.L.,ROUKIS,T

5、.S.DIABETIC FOOT AND ANKLE 3,2012OSTEOMYELITISCONTIGUOUS SPEAD OSTEOMYELITISCONTIGUOUS SPEAD OSTEOMYELITISCIERNY/MADER STAGE 2,3:MANAGEMENTABSCESSULCERATIONMARGIN OF BONERESECTIONBONE FOR C+SBONE FOR HISTOLOGYMANAGEMENTIMPLANTATION OF ANTIBIOTICBEADSANTIBIOTICMANAGEMENTADJUNCTIVE THERAPIESMANAGEMENT

6、 OF DIABETESNUTRITIONAL SUPPORTDURATION OF THERAPYDURATION OF THERAPYKosinski&Lipsky.Kosinski&Lipsky.Expert Rev Anti Infect Ther.Expert Rev Anti Infect Ther.2010;8(11):12932010;8(11):1293-13051305IWGDF SUMMARY:DURATION OF ANTIBIOTIC THERAPYINFECTION SEVERITY ROUTEDURATIONMILD INFECTIONORAL1-2 WEEKSM