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Avoiding amputation: Early infection intervention can save feet & legs

ANN ARBOR, Mich. -- A small sore on a toe may not seem like a major medical threat. But for the millions of people who have diabetes and other conditions, it can be the first step on a road that leads to the amputation of a foot -- or even a leg.

Now, a new study from the University of Michigan Cardiovascular Center may help more people save their limbs. Published in the June issue of the Annals of Surgery, it's the first-ever large study of how foot-bone infection, called osteomyelitis, is typically treated and how well the different approaches work.

Because diabetes interferes with the body's ability to heal, even the smallest foot wounds can become infected, spread to the bone, and lead to an amputation. Poor circulation and numb feet, also common in people with diabetes, make the situation worse. More than 80,000 such amputations happen each year in the United States. Experts already recommend that people with diabetes take special care of their feet and have regular foot exams to spot problems early.

The study is the first large account of the prevalence, treatment characteristics and high cost of treating osteomyelitis, which interferes with walking and sends thousands of people to the hospital each year.

On average, it shows, patients stayed in the hospital for about a week at an average cost of $19,000. Almost one in every thousand hospitalizations may be due to foot osteomyelitis, the study suggests.

"This study grew out of our own observations that many osteomyelitis patients were being treated for months or even years with antibiotics, but not healing, and this can contribute to the loss of their foot or leg," says lead author Peter Henke, M.D., an assistant professor of vascular surgery at the U-M Medical School. "But there's little evidence to guide treatment, so we wanted to look at epidemiology and outcomes. Our results show this is a common, costly issue that needs much further study."

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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
15-Jun-2005


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