Plekkenpol, Luca (2025) Non-Surgical Treatment of Diabetic Foot Osteomyelitis: Duration and Plantar Aspect of Diabetic Foot Ulcers as Predictors of Treatment Failure. thesis, Medicine.
Full text available on request.Abstract
Background: Diabetic foot ulcers complicated by osteomyelitis (DFO) are associated with significant morbidity and an elevated risk of amputation. Non-surgical treatments fail in 20-40% of patients, after which surgical treatment is required. This study aimed to identify predictors associated with failure of non-surgical treatment. Methods: For this study, data from a prospective multicenter observational study was utilized, in which patients with forefoot DFO were enrolled from ten peripheral hospitals in the Netherlands. The primary outcome measure was treatment failure, defined as persistent clinical signs of infection with either progressive signs of bone destruction on imaging or a persistently positive probe-to-bone-test. Associations were investigated using logistic regression analysis. Results: We included 69 patients, of whom 47 (68%) had treatment failure. In multivariable logistic regression analysis, ulcer duration (OR = 1.01 per day, 95% CI: 1.00–1.02, p = 0.01) and plantar ulcer location (OR = 7.80, 95% CI: 1.86–45.64, p = 0.01) were significantly associated with treatment failure. Conclusion: A relatively high proportion of patients (68%) experienced failure of non-surgical treatment for DFO, with longer ulcer duration and plantar ulcer location as significant risk factors. These characteristics may help identify patients at increased risk of treatment failure, warranting close monitoring and timely surgical intervention to improve outcomes.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Cate, Drs. W.A. ten and Hutting, Drs. K.H. |
| Faculty: | Medical Sciences |
| Date Deposited: | 22 Apr 2026 13:04 |
| Last Modified: | 22 Apr 2026 13:04 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3931 |
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