The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons
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The purpose of this study was to investigate factors that contribute to the development of osteomyelitis of the foot after a puncture wound in patients with diabetes. Forty-five male and 21 female adults with diabetes that were admitted to the hospital for a foot infection precipitated by a puncture were included in the study. Twenty-two (33%) patients had osteomyelitis (O) based on either a positive bone culture or pathology report. ⋯ A significant difference was identified when comparing the time interval from the time of the injury until patients were hospitalized and until they had the puncture wound surgically debrided, and when comparing the interval from when patients first received initial professional medical evaluation until they were hospitalized and until they had the puncture wound surgically debrided. Patients with punctures involving the forefoot (FF) and patients that wore shoes (S) at the time of the injury were more likely to develop osteomyelitis than patients that had rearfoot (RF) injuries O: FF = 20, 90%, RF = 2, 10%, ST: FF = 30, 70%, RF = 13, 30%, p < 0.05) and patients that were barefoot (B) at the time of injury (O: S = 15, 88%, B = 2, 12%, ST: S = 21, 57%, B = 16, 43%, p < 0.05). Osteomyelitis is a common complication in patients with diabetes with a foot infection following a puncture wound.(ABSTRACT TRUNCATED AT 250 WORDS)
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A retrospective study was undertaken to determine the importance of performing noninvasive blood flow studies on the diabetic patient population prior to undergoing elective foot surgery. Thirty diabetic patients, contemplating elective foot surgery, underwent noninvasive blood flow studies. Eighty-seven percent of these patients, with ankle/brachial indices greater than 0.6, successfully healed after surgery was performed.
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Complications from lower extremity pneumatic tourniquet use can range from transient to devastating. A major factor that can lead to complications is simply the applied site pressure. Recent advancements in tourniquet design, including increased width and curve allow for consistent hemostasis at pressures as low as 200 mm. ⋯ The Zimmer Automatic Tourniquet System (A. T. S.) Low Pressure Cuffs were followed at these minimal pressures with promising results.