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Poster
EBP-002
Early Clinical Recognition of Chronic Osteomyelitis in the Diabetic Foot Wound
Introduction: In a PT-driven wound clinic without physician oversight, it is important to clinically recognize chronic osteomyelitis in a diabetic foot wound to expedite early and appropriate treatment. As PTs, we cannot order imaging, labs or write referrals to other disciplines requiring us to reach out to providers with our recommendations.Methods:Regardless of your profession, early clinical recognition of chronic osteomyelitis can expedite appropriate imaging and treatment; including, imaging to confirm osteomyelitis and rule out arterial disease, early antibiotic treatment along with appropriate debridement, topical management and proper offloading with the gold standard being a total contact cast.Results:Optimizing outcomes for limb preservation includes appropriate antibiotic management, controlling diabetes, smoking cessation and appropriate offloading. The more chronic a wound is, the more likely it is to require surgical resection.Discussion: Early diagnosis is essential in preventing surgical measures. The assessment of arterial perfusion is recommended by evidence-based guidelines for treatment of patients with lower extremity wounds. In patients with diabetes, TcPO2s can determine healing potential. Further research needs to be completed on removable offloading devices and their effectiveness on healing plantar diabetic foot wounds when the total contact cast is not appropriate.References: Arnold JF, Marmolejo V. Outcomes achieved with use of a prefabricated roll-on total contact cast. Foot Ankle Int. 2017;38(10):1126-1131.
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