Diabetic Foot Infection
20% of diabetic patients with infected foot ulcers have underlying osteomyelitis (Lipsky. 2014) and Murphy-Lavoie et al. report that 15% of diabetic patients will require an amputation (Murphy-Lavoie et al. 2020), but this can lead down a pathway of recurring infection and progressing higher amputations.
CERAMENT G remodels into bone whilst eluting antibiotic at high concentrations locally to protect the bone healing process. The antibiotic-eluting CERAMENT products offers the opportunity to pursue an alternative limb-sparing or salvage surgical pathway. Please have a look at our materials below on how to use antibiotic-eluting CERAMENT for best outcomes, example cases and clinical results.
Limb Salvage Surgery in Diabetic Foot Infection: Encouraging Early Results with a Local Antibiotic Carrier
Authors: Chow et al.
Publication: ANZ Journal of Surgery (2024)
Summary: Single-stage procedure including debridement and using CERAMENT G or CERAMENT® V with Vancomycin*(protocolized, 103 patients) vs. debridement without local antibiotics delivery (conventional, 33 patients). *Availability of CERAMENT is dependent on regulatory status in individual markets, contact your local representative.
Results:
- Fewer operations (1.2 vs. 3.5 per patient)
- Shorter hospital stay (12.6 vs. 25.1 days)
- Lower amputation rate (2% vs. 18%)
Adjuvant local antibiotic therapy in the management of diabetic foot osteomyelitis
Authors: Metaoy et al.
Publication: Clinical Diabetes and Endocrinology (2024)
Summary: Retrospective single center study with 105 consecutive patients, where 56 received additional local antibiotic therapy (LAB) and 49 patients received current standard of care without local antibiotic therapy (NLAB, conventional). Mean follow-up 14 months.
Results:
- Lower five-year mortality rate (12.5% vs 55.1%, p<0.00001)
- Lower amputation rate (1.78% vs 12.24%, p=0.0484)
- Improved infection healing (73.21% vs 20.41%, p<0.0001)
- Persistence of infection with no evidence of wound healing at 6 months from surgery (7.14% vs 30.61%, p=0.00183)
Limb Salvage Surgery in Diabetic Foot Infection: Encouraging Early Results with a Local Antibiotic Carrier
Authors: Vasukutty et al.
Publication: The Diabetic Foot Journal (2022)
Summary: Patients with diabetic foot osteomyelitis treated by debridement or reconstructive surgery, with CERAMENT® G used to manage the dead space, followed up for a mean of 33 months.
Results:
- 47 patients
- 94% limb salvage rate
- 88% infection control and healing
Adjuvant Antibiotic Loaded Bio Composite in the Management of Diabetic Foot Osteomyelitis – A Multicentre Study
Authors: Niazi et al.
Publication: The Foot (2019)
Summary: Patients with diabetic foot ulcers and osteomyelitis treated by surgery, CERAMENT® G and systemic antibiotic, followed up until infection eradication or ulcer healing – mean 10 months.
Results:
- 70 patients
- 90% infection eradication
- 12 week mean ulcer healing time
Single Stage Treatment of Diabetic Calcaneal Osteomyelitis with an Absorbable Gentamicin-Loaded Calcium Sulphate/Hydroxyapatite Composite: The Silo Technique
Authors: Drampalos et al.
Publication: The Foot (2017)
Summary: Description of a novel bone-preserving technique for the treatment of calcaneal osteomyelitis in diabetic patients, using CERAMENT® G. Patients were followed up until ulcer healing – mean 16 weeks.
Results:
- 12 patients
- 0 fractures
- 100% infection eradication