• 1
    Lipsky BA, Berendt AR, Embil J, de Lalla F. Diagnosing and treating diabetic foot infections. Diabetes Metab Res Rev 2004; 20(Suppl 1): S56S64.
  • 2
    Berendt AR, Peters EJ, Bakker K, et al. Diabetic foot osteomyelitis: a progress report on diagnosis and a systematic review of treatment. Diabetes Metab Res Rev 2008; 24(Suppl 1): S145S161.
  • 3
    Peters EJ, Lavery LA, Urbancic V, et al. A systematic review of the effectiveness of interventions in the management of infection in the diabetic foot. Diabetes Metab Res Rev 2012; 28(Suppl. 1): X-XX.
  • 4
    International Working Group on the Diabetic Foot. International Consensus on the Diabetic Foot and Supplements, DVD. International Diabetes Federation: Amsterdam, the Netherlands, 2007.
  • 5
    Pecoraro RE. Chronology and determinants of tissue repair in diabetic lower extremity ulcers. Diabetes. 1991; 40: 13051313.
  • 6
    Pecoraro RG. Risk factors for amputation in patients with diabetes mellitus: a case control study. Ann Intern Med. 1992; 117(2): 97105.
  • 7
    Lipsky BA. Infectious problems of the foot in diabetic patients. InIn The Diabetic Foot (6th ed edn), Bowker JH, Pfeifer MA (eds). : Mosby, St. Louis, 2001; 467480.
  • 8
    Lavery LA, Armstrong DG, Wunderlich RP, Mohler MJ, Wendel CS, Lipsky BA. Risk factors for foot infections in individuals with diabetes. Diabetes Care. 2006; 29(6): 12881293.
  • 9
    Prompers L, Schaper N, Apelqvist J, et al. Prediction of outcome in individuals with diabetic foot ulcers: focus on the differences between individuals with and without peripheral arterial disease. The EURODIALE Study. Diabetologia. 2008; 51(5): 747755.
  • 10
    Wilson RM. Neutrophil function in diabetes. Diabet Med. 1986; 6: 50912.
  • 11
    Bistrian MM. Host defenses and susceptibility to infection in patients with diabetes mellitus. Infect Dis Clin North Am. 1995; 9(1): 19.
  • 12
    Sentochnik DE, Eliopoulos GM. Infection and diabetes. In Joslin's Diabetes Mellitus (13th ed edn), Kahn CR, Weir GC (eds). Lea & Febiger: Philadelphia, 1994; 867868.
  • 13
    Bridges RM, Jr., Deitch EA. Diabetic foot infections. Pathophysiology and treatment. Surg Clin North Am. 1994; 74(3): 537555.
  • 14
    Lavery LA, Peters EJ, Williams JR, Murdoch DP, Hudson A, Lavery DC. Reevaluating the way we classify the diabetic foot: restructuring the diabetic foot risk classification system of the International Working Group on the Diabetic Foot. Diabetes Care. 2008; 31(1): 1546.
  • 15
    Lavery LA, Armstrong DG, Murdoch DP, Peters EJ, Lipsky BA. Validation of the Infectious Diseases Society of America's diabetic foot infection classification system. Clin Infect Dis. 2007; 44(4): 5625.
  • 16
    Lipsky BA, Berendt AR, Deery HG, et al. Diagnosis and treatment of diabetic foot infections. Clin Infect Dis. 2004; 39(7): 885910.
  • 17
    Gardner SE, Hillis SL, Frantz RA. Clinical signs of infection in diabetic foot ulcers with high microbial load. Biol Res Nurs. 2009; 11(2): 119128.
  • 18
    Cutting KF, White R. Defined and refined: criteria for identifying wound infection revisited. Br J Community Nurs. 2004; 9(3): S6S15.
  • 19
    Edelson GW, Armstrong DG, Lavery LA, Caicco G. The acutely infected diabetic foot is not adequately evaluated in an inpatient setting. Arch Intern Med. 1996; 156(20): 23736.
  • 20
    Eneroth M, Apelqvist J, Stenstrom A. Clinical characteristics and outcome in 223 diabetic patients with deep foot infections. Foot Ankle Int. 1997; 18(11): 716722.
  • 21
    Armstrong DG, Perales TA, Murff RT, Edelson GW, Welchon JG. Value of white blood cell count with differential in the acute diabetic foot infection. J Am Podiatr Med Assoc. 1996; 86(5): 2247.
  • 22
    Aragón-Sánchez J. Seminar review: a review of the basis of surgical treatment of diabetic foot infections. Int J Low Extrem Wounds. 2011; 10(1): 3365.
  • 23
    Teh J, Berendt T, Lipsky BA. Rational imaging. Investigating suspected bone infection in the diabetic foot. BMJ. 2009; 339: b4690.
  • 24
    Butalia S, Palda VA, Sargeant RJ, Detsky AS, Mourad O. Does this patient with diabetes have osteomyelitis of the lower extremity? JAMA 2008; 299(7): 806813.
  • 25
    Dinh MT, Abad CL, Safdar N. Diagnostic accuracy of the physical examination and imaging tests for osteomyelitis underlying diabetic foot ulcers: meta-analysis. Clin Infect Dis. 2008; 47(4): 519527.
  • 26
    Newman LG, Waller J, Palestro CJ, et al. Unsuspected osteomyelitis in diabetic foot ulcers. Diagnosis and monitoring by leukocyte scanning with indium in 111 oxyquinoline. JAMA 1991; 266(9): 124651.
  • 27
    Ertugrul MB, Baktiroglu S, Salman S, Unal S, Aksoy M, Berberoglu K, Calangu S. The diagnosis of osteomyelitis of the foot in diabetes: microbiological examination vs. magnetic resonance imaging and labelled leucocyte scanning. Diabet Med. 2006; 23(6): 649653.
  • 28
    Aragón-Sánchez J, Lipsky BA, Lázaro-Martínez JL. Diagnosing diabetic foot osteomyelitis: is the combination of probe-to-bone test and plain radiography sufficient for high-risk inpatients? Diabet Med. 2011; 28(2): 191194.
  • 29
    Morales LR, González Fernández ML, Martinez HD, Beneit Montesinos JV, Guisado Jiménez S, Gonzalez Jurado MA. Validating the probe-to-bone and other tests for diagnosing chronic osteomyelitis in the diabetic foot. Diabetes Care 2010; 33(10): 21402145.
  • 30
    Grayson ML, Gibbons GW, Balogh K, Levin E, Karchmer AW. Probing to bone in infected pedal ulcers. A clinical sign of underlying osteomyelitis in diabetic patients. JAMA 1995; 273(9): 721723.
  • 31
    Shone A, Burnside J, Chipchase S, Game F, Jeffcoate W. Probing the validity of the probe-to-bone test in the diagnosis of osteomyelitis of the foot in diabetes. Diabetes Care. 2006; 29(4): 945.
  • 32
    Lavery LA, Armstrong DG, Peters EJ, Lipsky BA. Probe-to-bone test for diagnosing diabetic foot osteomyelitis: reliable or relic? Diabetes Care. 2007; 30(2): 2704.
  • 33
    Kaleta JL, Fleischli JW, Reilly CH. The diagnosis of osteomyelitis in diabetes using erythrocyte sedimentation rate: a pilot study. J Am Podiatr Med Assoc. 2001; 91(9): 445450.
  • 34
    Armstrong DG, Lavery LA, Sariaya M, Ashry H. Leukocytosis is a poor indicator of acute osteomyelitis of the foot in diabetes mellitus. J Foot Ankle Surg. 1996; 35(4): 280283.
  • 35
    Dinh T, Snyder G, Veves A. Current techniques to detect foot infection in the diabetic patient Int J Low Extrem Wounds. 2010; 9(1): 2430.
  • 36
    Weinstein D, Wang A, Chambers R, Stewart CA, Motz HA. Evaluation of magnetic resonance imaging in the diagnosis of osteomyelitis in diabetic foot infections. Foot Ankle. 1993; 14(1): 1822.
  • 37
    Mettler MA. Essentials of Radiology. Philadephia, PA: Elsevier Saunders, 2005.
  • 38
    Yuh WT, Corson JD, Baraniewski HM, et al. Osteomyelitis of the foot in diabetic patients: evaluation with plain film, 99mTc-MDP bone scintigraphy, and MR imaging. AJR Am J Roentgenol. 1989; 152(4): 795800.
  • 39
    Wang A, Weinstein D, Greenfield L, et al. MRI and diabetic foot infections. Magn Reson Imaging. 1990; 8(6): 805809.
  • 40
    Johnson JE, Kennedy EJ, Shereff MJ, Patel NC, Collier BD. Prospective study of bone, indium-111-labeled white blood cell, and gallium-67 scanning for the evaluation of osteomyelitis in the diabetic foot. Foot Ankle Int. 1996; 17(1): 1016.
  • 41
    Enderle MD, Coerper S, Schweizer HP, et al. Correlation of imaging techniques to histopathology in patients with diabetic foot syndrome and clinical suspicion of chronic osteomyelitis. The role of high-resolution ultrasound. Diabetes Care. 1999; 22(2): 294299.
  • 42
    Lee SM, Lee RG, Wilinsky J, Balogh K, Clouse ME. Magnification radiography in osteomyelitis. Skeletal Radiol. 1986; 15(8): 625627.
  • 43
    Park HM, Wheat LJ, Siddiqui AR, et al. Scintigraphic evaluation of diabetic osteomyelitis: concise communication. J Nucl Med. 1982; 23(7): 569573.
  • 44
    Shults DW, Hunter GC, McIntyre KE, Parent FN, Piotrowski JJ, Bernhard VM. Value of radiographs and bone scans in determining the need for therapy in diabetic patients with foot ulcers. Am J Surg. 1989; 158(6): 525529.
  • 45
    Croll SD, Nicholas GG, Osborne MA, Wasser TE, Jones S. Role of magnetic resonance imaging in the diagnosis of osteomyelitis in diabetic foot infections. J Vasc Surg. 1996; 24(2): 266270.
  • 46
    Keenan AM, Tindel NL, Alavi A. Diagnosis of pedal osteomyelitis in diabetic patients using current scintigraphic techniques. Arch Intern Med. 1989; 149(10): 22622266.
  • 47
    Larcos G, Brown ML, Sutton RT. Diagnosis of osteomyelitis of the foot in diabetic patients: value of 11In-leukocyte scintigraphy. AJR Am J Roentgenol. 1991; 157(3): 527531.
  • 48
    Seldin DW, Heiken JP, Feldman F, Alderson PO. Effect of soft-tissue pathology on detection of pedal osteomyelitis in diabetics. J Nucl Med. 1985; 26(9): 988993.
  • 49
    Levine SE, Neagle CE, Esterhai JL, Wright DG, Dalinka MK. Magnetic resonance imaging for the diagnosis of osteomyelitis in the diabetic patient with a foot ulcer. Foot Ankle Int. 1994; 15(3): 151156.
  • 50
    Oyen WJ, Netten PM, Lemmens JA, et al. Evaluation of infectious diabetic foot complications with indium-111-labeled human nonspecific immunoglobulin G. J Nucl Med. 1992; 33(7): 13301336.
  • 51
    Vesco L, Boulahdour H, Hamissa S, et al. The value of combined radionuclide and magnetic resonance imaging in the diagnosis and conservative management of minimal or localized osteomyelitis of the foot in diabetic patients. Metab Clin Exp. 1999; 48(7): 922927.
  • 52
    Harwood SJ, Valdivia S, Hung GL, Quenzer RW. Use of Sulesomab, a radiolabeled antibody fragment, to detect osteomyelitis in diabetic patients with foot ulcers by leukoscintigraphy. Clin Infect Dis. 1999; 28(6): 12001205.
  • 53
    Blume PA, Dey HM, Daley LJ, Arrighi JA, Soufer R, Gorecki GA. Diagnosis of pedal osteomyelitis with Tc-99m HMPAO labeled leukocytes. J Foot Ankle Surg. 1997; 36(2): 120126.
  • 54
    Newman LG, Waller J, Palestro CJ, et al. Leukocyte scanning with 111In is superior to magnetic resonance imaging in diagnosis of clinically unsuspected osteomyelitis in diabetic foot ulcers. Diabetes Care. 1992; 15(11): 152730.
  • 55
    Kapoor A, Page S, Lavalley M, Gale DR, Felson DT. Magnetic resonance imaging for diagnosing foot osteomyelitis: a meta-analysis. Arch Intern Med. 2007; 167(2): 125132.
  • 56
    Craig JG, Amin MB, Wu K, et al. Osteomyelitis of the diabetic foot: MR imaging-pathologic correlation. Radiology. 1997; 203(3): 849855.
  • 57
    Horowitz JD, Durham JR, Nease DB, Lukens ML, Wright JG, Smead WL. Prospective evaluation of magnetic resonance imaging in the management of acute diabetic foot infections. Ann Vasc Surg. 1993; 7(1): 4450.
  • 58
    Kearney T, Pointin K, Cunningham D, Gedroyc W, Robinson S, Elkeles RS. The detection of pedal osteomyelitis in diabetic patients. Pract Diabetes Int. 1999; 16: 98100.
  • 59
    Ledermann HP, Schweitzer ME, Morrison WB. Nonenhancing tissue on MR imaging of pedal infection: characterization of necrotic tissue and associated limitations for diagnosis of osteomyelitis and abscess. AJR Am J Roentgenol. 2002; 178(1): 215222.
  • 60
    Lipman BT, Collier BD, Carrera GF, et al. Detection of osteomyelitis in the neuropathic foot: nuclear medicine, MRI and conventional radiography. Clin Nucl Med. 1998; 23(2): 7782.
  • 61
    Maas M, Slim EJ, Hoeksma AF, et al. MR imaging of neuropathic feet in leprosy patients with suspected osteomyelitis. Int J Lepr Other Mycobact Dis 2002; 70(2): 97103.
  • 62
    Morrison WB, Schweitzer ME, Batte WG, Radack DP, Russel KM. Osteomyelitis of the foot: relative importance of primary and secondary MR imaging signs. Radiology. 1998; 207(3): 625632.
  • 63
    Nigro ND, Bartynski WS, Grossman SJ, Kruljac S. Clinical impact of magnetic resonance imaging in foot osteomyelitis. J Am Podiatr Med Assoc. 1992; 82(12): 603615.
  • 64
    Remedios D, Valabhji J, Oelbaum R, Sharp P, Mitchell R. 99mTc-nanocolloid scintigraphy for assessing osteomyelitis in diabetic neuropathic feet. Clin Radiol. 1998; 53(2): 120125.
  • 65
    Capriotti G, Chianelli M, Signore A. Nuclear medicine imaging of diabetic foot infection: results of meta-analysis. Nucl Med Commun. 2006; 27(10): 757764.
  • 66
    Devillers A, Moisan A, Hennion F, Garin E, Poirier JY, Bourguet P. Contribution of technetium-99m hexamethylpropylene amine oxime labelled leucocyte scintigraphy to the diagnosis of diabetic foot infection. Eur J Nucl Med. 1998; 25(2): 132138.
  • 67
    Harvey J, Cohen MM. Technetium-99-labeled leukocytes in diagnosing diabetic osteomyelitis in the foot. J Foot Ankle Surg. 1997; 36(3): 209214.
  • 68
    Palestro CJ, Love C. Nuclear medicine and diabetic foot infections. Semin Nucl Med. 2009; 39(1): 5265.
  • 69
    Unal SN, Birinci H, Baktiroglu S, Cantez S. Comparison of Tc-99m methylene diphosphonate, Tc-99m human immune globulin, and Tc-99m-labeled white blood cell scintigraphy in the diabetic foot. Clin Nucl Med. 2001; 26(12): 10161021.
  • 70
    Williamson BR, Teates CD, Phillips CD, Croft BY. Computed tomography as a diagnostic aid in diabetic and other problem feet. Clin Imaging. 1989; 13(2): 159163.
  • 71
    Keidar Z, Militianu D, Melamed E, Bar-Shalom R, Israel O. The diabetic foot: initial experience with 18F-FDG PET/CT. J Nucl Med. 2005; 46(3): 444449.
  • 72
    Nawaz A, Torigian DA, Siegelman ES, Basu S, Chryssikos T, Alavi A. Diagnostic performance of FDG-PET, MRI, and plain film radiography (PFR) for the diagnosis of osteomyelitis in the diabetic foot. Mol Imaging Biol. 2010; 12(3): 335342.
  • 73
    Elamurugan TP, Jagdish S, Kate V, Chandra Parija S. Role of bone biopsy specimen culture in the management of diabetic foot osteomyelitis. Int J Surg. 2011; 9(3): 214216.
  • 74
    Ertugrul MB, Baktiroglu S, Salman S, et al. Pathogens isolated from deep soft tissue and bone in patients with diabetic foot infections. J Am Podiatr Med Assoc. 2008; 98(4): 290295.
  • 75
    Chantelau E, Wolf A, Ozdemir S, Hachmoller A, Ramp U. Bone histomorphology may be unremarkable in diabetes mellitus. Med Klin (Munich). 2007; 102(6): 429433.
  • 76
    Weiner RD, Viselli SJ, Fulkert KA, Accetta P. Histology versus microbiology for accuracy in identification of osteomyelitis in the diabetic foot. J Foot Ankle Surg. 2011; 50(2): 197200.
  • 77
    Senneville E, Lombart A, Beltrand E, et al. Outcome of diabetic foot osteomyelitis treated nonsurgically: a retrospective cohort study. Diabetes Care. 2008; 31(4): 637642.
  • 78
    Lipsky BA. Bone of contention: diagnosing diabetic foot osteomyelitis Clin Infect Dis. 2008; 47(4): 528530.
  • 79
    Lesens O, Desbiez F, Vidal M, et al. Culture of per-wound bone specimens: a simplified approach for the medical management of diabetic foot osteomyelitis Clin Microbiol Infect. 2011; 17(2): 285291.
  • 80
    Senneville E, Melliez H, Beltrand E, et al. Culture of percutaneous bone biopsy specimens for diagnosis of diabetic foot osteomyelitis: concordance with ulcer swab cultures. Clin Infect Dis. 2006; 42(1): 5762.
  • 81
    Schaper NC. Diabetic foot ulcer classification system for research purposes: a progress report on criteria for including patients in research studies. Diabetes Metab Res. 2004; 20(Suppl 1): 905.
  • 82
    Lipsky BA, Pecoraro RE, Wheat LJ. The diabetic foot. Soft tissue and bone infection. Infect Dis Clin North Am. 1990; 4(3): 409432.
  • 83
    Armstrong DG, Lavery LA, Harkless LB. Validation of a diabetic wound classification system. The contribution of depth, infection, and ischemia to risk of amputation. Diabetes Care. 1998; 21(5): 855859.
  • 84
    Lipsky BA, Polis AB, Lantz KC, Norquist JM, Abramson MA. The value of a wound score for diabetic foot infections in predicting treatment outcome: a prospective analysis from the SIDESTEP trial. Wound Repair Regeneration. 2009; 17(5): 671677.
  • 85
    Lipsky BA, Tabak YP, Johannes RS, Vo L, Hyde L, Weigelt JA. Skin and soft tissue infections in hospitalised patients with diabetes: culture isolates and risk factors associated with mortality, length of stay and cost Diabetologia. 2010; 53(5): 914923.
  • 86
    Ger R. Newer concepts in the surgical management of lesions of the foot in the patient with diabetes. Surg Gynecol Obstet. 1984; 158(3): 213215.
  • 87
    Wheat LJ, Allen SD, Henry M, et al. Diabetic foot infections. Bacteriologic analysis. Arch Intern Med. 1986; 146(10): 19351940.
  • 88
    Singh SK, Gupta K, Tiwari S, et al. Detecting aerobic bacterial diversity in patients with diabetic foot wounds using ERIC-PCR: a preliminary communication Int J Low Extrem Wounds. 2009; 8(4): 203208.
  • 89
    Dowd SE, Wolcott RD, Sun Y, McKeehan T, Smith E, Rhoads D. Polymicrobial nature of chronic diabetic foot ulcer biofilm infections determined using bacterial tag encoded FLX amplicon pyrosequencing (bTEFAP). PLoS One. 2008; 3(10): e3326.
  • 90
    Pellizzer G, Strazzabosco M, Presi S, et al. Deep tissue biopsy vs. superficial swab culture monitoring in the microbiological assessment of limb-threatening diabetic foot infection. Diabet Med. 2001; 18(10): 8227.
  • 91
    Lipsky BA, Pecoraro RE, Larson SA, Hanley ME, Ahroni JH. Outpatient management of uncomplicated lower-extremity infections in diabetic patients. Arch Intern Med. 1990; 150(4): 790797.
  • 92
    Citron DM, Goldstein EJ, Merriam CV, Lipsky BA, Abramson MA. Bacteriology of moderate-to-severe diabetic foot infections and in vitro activity of antimicrobial agents. J Clin Microbiol 2007; 45(9): 28192828.
  • 93
    Martínez-Gómez DA, Ramírez-Almagro C, Campillo-Soto A, Morales-Cuenca G, Pagán-Ortiz J, Aguayo-Albasini JL. Diabetic foot infections. Prevalence and antibiotic sensitivity of the causative microorganisms. Enferm Infecc Microbiol Clin. 2009; 27(9): 317321.
  • 94
    Bansal E, Garg A, Bhatia S, Attri AK, Chander J. Spectrum of microbial flora in diabetic foot ulcers. Indian J Pathol Microbiol. 2008; 51(2): 204208.
  • 95
    Yoga R, Khairul A, Sunita K, Suresh C. Bacteriology of diabetic foot lesions. Med J Malaysia. 2006; 61(Suppl A): 1416.
  • 96
    Shakil S, Khan AU. Infected foot ulcers in male and female diabetic patients: a clinico-bioinformative study. Ann Clin Microbiol Antimicrob. 2010; 9: 2.
  • 97
    Gerding DN. Foot infections in diabetic patients: the role of anaerobes. Clin Infect Dis. 1995; 20(Suppl 2): S283S288.
  • 98
    Tentolouris N, Jude EB, Smirnof I, Knowles EA, Boulton AJ. Methicillin-resistant Staphylococcus aureus: an increasing problem in a diabetic foot clinic. Diabet Med 1999; 16(9): 767771.
  • 99
    Dang CN, Prasad YD, Boulton AJ, Jude EB. Methicillin-resistant Staphylococcus aureus in the diabetic foot clinic: a worsening problem. Diabet Med. 2003; 20(2): 159161.
  • 100
    Eleftheriadou I, Tentolouris N, Argiana V, Jude E, Boulton AJ. Methicillin-resistant Staphylococcus aureus in diabetic foot infections. Drugs 2010; 70(14): 17851797.
  • 101
    Lagace-Wiens PR, Ormiston D, Nicolle LE, Hilderman T, Embil J. The diabetic foot clinic: not a significant source for acquisition of methicillin-resistant Staphylococcus aureus. Am J Infect Control 2009; 37(7): 587589.
  • 102
    Wagner A, Reike H, Angelkort B. Erfahrungen im Umgang mit hochresistenten Keimen bei Patienten mit diabetischem Fuß-Syndrom unter besonderer Berücksichtigung von MRSA-Infektionen. [Highly resistant pathogens in patients with diabetic foot syndrome with special reference to methicillin-resistant Staphylococcus aureus infections]. Dtsch Med Wochenschr. 2001; 126(48): 13531356.
  • 103
    Vardakas KZ, Horianopoulou M, Falagas ME. Factors associated with treatment failure in patients with diabetic foot infections: an analysis of data from randomized controlled trials. Diabetes Res Clin Pract. 2008; 80(3): 344351.
  • 104
    Bowling FL, Jude EB, Boulton AJ. MRSA and diabetic foot wounds: contaminating or infecting organisms? Curr Diab Rep. 2009; 9(6): 440444.
  • 105
    Varaiya AY, Dogra JD, Kulkarni MH, Bhalekar PN. Extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae in diabetic foot infections. Indian J Pathol Microbiol. 2008; 51(3): 370372.
  • 106
    Zubair M, Malik A, Ahmad J. Clinico-microbiological study and antimicrobial drug resistance profile of diabetic foot infections in North India. Foot (Edinb) 2011; 21(1): 614.
  • 107
    Dowd SE, Delton Hanson J, Rees E, et al. Survey of fungi and yeast in polymicrobial infections in chronic wounds. J Wound Care 2011; 20(1): 4047.
  • 108
    Lipsky BA. Osteomyelitis of the foot in diabetic patients. Clin Infect Dis 1997; 25(6): 131826.
  • 109
    Berendt AR, Lipsky B. Is this bone infected or not? Differentiating neuro-osteoarthropathy from osteomyelitis in the diabetic foot. Curr Diab Rep. 2004; 4(6): 424429.
  • 110
    Tan JS, Friedman NM, Hazelton-Miller C, Flanagan JP, File TMJ. Can aggressive treatment of diabetic foot infections reduce the need for above-ankle amputation? Clin Infect Dis. 1996; 23(2): 286291.
  • 111
    Faglia E, Clerici G, Caminiti M, Quarantiello A, Gino M, Morabito A. The role of early surgical debridement and revascularization in patients with diabetes and deep foot space abscess: retrospective review of 106 patients with diabetes. J Foot Ankle Surg. 2006; 45(4): 220226.
  • 112
    Aragón-Sánchez J. Treatment of diabetic foot osteomyelitis: a surgical critique. Int J Low Extrem Wounds. 2010; 9(1): 3759.
  • 113
    Armstrong DG, Lipsky BA. Diabetic foot infections: stepwise medical and surgical management. Int Wound J. 2004; 1(2): 123132.
  • 114
    Robson MC, Mannari RJ, Smith PD, Payne WG. Maintenance of wound bacterial balance. Am J Surg. 1999; 178(5): 399402.
  • 115
    O'Meara SM, Cullum NA, Majid M, Sheldon TA. Systematic review of antimicrobial agents used for chronic wounds. Br J Surg. 2001; 88(1): 421.
  • 116
    Chantelau E, Tanudjaja T, Altenhofer F, Ersanli Z, Lacigova S, Metzger C. Antibiotic treatment for uncomplicated neuropathic forefoot ulcers in diabetes: a controlled trial. Diabet Med. 1996; 13(2): 156159.
  • 117
    Hirschl M, Hirschl AM. Bacterial flora in mal perforant and antimicrobial treatment with ceftriaxone. Chemotherapy. 1992; 38(4): 275280.
  • 118
    Foster AVM, Bates M, Doxford M, Edmonds ME. Should oral antibiotics be given to “clean” foot ulcers with no cellulitis?. In Abstract International Working Group on the Diabetic Foot. : Noordwijkerhout, Netherlands, 1999.
  • 119
    Majcher-Peszynska J, Sass M, Schipper S, et al. Pharmacokinetics and penetration of moxifloxacin into infected diabetic foot tissue in a large diabetic patient cohort. Eur J Clin Pharmacol 2011; 67(2): 135142.
  • 120
    Kuck EM, Bouter KP, Hoekstra JB, Conemans JM, Diepersloot RJ. Tissue concentrations after a single-dose, orally administered ofloxacin in patients with diabetic foot infections. Foot Ankle Int. 1998; 19(1): 3840.
  • 121
    Muller M, Brunner M, Hollenstein U, et al. Penetration of ciprofloxacin into the interstitial space of inflamed foot lesions in non-insulin-dependent diabetes mellitus patients. Antimicrob Agents Chemother. 1999; 43(8): 20562058.
  • 122
    Marangos MN, Skoutelis AT, Nightingale CH, et al. Absorption of ciprofloxacin in patients with diabetic gastroparesis. Antimicrob Agents Chemother. 1995; 39(9): 21612163.
  • 123
    Raymakers JT, Houben AJ, van dH Tordoir JH, Kitslaar PJ, Schaper NC. The effect of diabetes and severe ischaemia on the penetration of ceftazidime into tissues of the limb. Diabet Med 2001; 18(3): 229234.
  • 124
    el Sherif el Sarky M. Local intravenous therapy in chronic inflammatory and vascular disorders of the foot. Int Surg 1997; 82(2): 175181.
  • 125
    de Lalla F, Novelli A, Pellizzer G, Milocchi F, Viola R, Rigon A, Stecca C, Dal Pizzol V, Fallani S, Periti P. Regional and systemic prophylaxis with teicoplanin in monolateral and bilateral total knee replacement procedures: study of pharmacokinetics and tissue penetration. Antimicrob Agents Chemother 1993; 37(12): 26932698.
  • 126
    Dorigo B, Cameli AM, Trapani M, Raspanti D, Torri M, Mosconi G. Efficacy of femoral intra-arterial administration of teicoplanin in gram-positive diabetic foot infections. Angiology. 1995; 46(12): 11151122.
  • 127
    Connolly JE, Wrobel JS, Anderson RF. Primary closure of infected diabetic foot wounds. A report of closed instillation in 30 cases. J Am Podiatr Med Assoc. 2000; 90(4): 175182.
  • 128
    Lipsky BA, Hoey C. Topical antimicrobial therapy for treating chronic wounds. Clin Infect Dis. 2009; 49(10): 15411549.
  • 129
    Lipsky BA, Holroyd KJ, Zasloff M. Topical versus systemic antimicrobial therapy for treating mildly infected diabetic foot ulcers: a randomized, controlled, double-blinded, multicenter trial of pexiganan cream. Clin Infect Dis. 2008; 47(12): 15371545.
  • 130
    Vermeulen H, van Hattem JM, Storm-Versloot MN, Ubbink DT. Topical silver for treating infected wounds. Cochrane Database Syst Rev 2007; (1): CD005486.
  • 131
    Storm-Versloot MN, Vos CG, Ubbink DT, Vermeulen H. Topical silver for preventing wound infection. Cochrane Database Syst Rev. 2010; (3): CD006478.
  • 132
    Silver dressings—do they work? Drug Ther Bull 2010; 48(4): 3842.
  • 133
    Roeder B, Van Gils CC, Maling S. Antibiotic beads in the treatment of diabetic pedal osteomyelitis. J Foot Ankle Surg. 2000; 39(2): 124130.
  • 134
    Yamashita Y, Uchida A, Yamakawa T, Shinto Y, Araki N, Kato K. Treatment of chronic osteomyelitis using calcium hydroxyapatite ceramic implants impregnated with antibiotic. Int Orthop. 1998; 22(4): 247251.
  • 135
    Barth RE, Vogely HC, Hoepelman AI, Peters EJ. To bead or not to bead? Treatment of osteomyelitis and prosthetic joint associated infections with gentamicin bead chains. Int J Antimicrob Agents 2011; 38(5): 371375.
  • 136
    Lipsky BA. Evidence-based antibiotic therapy of diabetic foot infections. FEMS Immunol Med Microbiol. 1999; 26(3–4): 267276.
  • 137
    Lipsky BA, Armstrong DG, Citron DM, Tice AD, Morgenstern DE, Abramson MA. Ertapenem versus piperacillin/tazobactam for diabetic foot infections (SIDESTEP): prospective, randomised, controlled, double-blinded, multicentre trial. Lancet. 2005; 366(9498): 16951703.
  • 138
    Cunha BA. Antibiotic selection for diabetic foot infections: a review. J Foot Ankle Surg. 2000; 39(4): 253257.
  • 139
    Byren I, Peters EJ, Hoey C, Berendt A, Lipsky BA. Pharmacotherapy of diabetic foot osteomyelitis Expert Opin Pharmacother. 2009; 10(18): 30333047.
  • 140
    Ragnarson Tennvall G, Apelqvist J, Eneroth M. Costs of deep foot infections in patients with diabetes mellitus. Pharmacoeconomics. 2000; 18(3): 225238..
  • 141
    McKinnon PS, Paladino JA, Grayson ML, Gibbons GW, Karchmer AW. Cost-effectiveness of ampicillin/sulbactam versus imipenem/cilastatin in the treatment of limb-threatening foot infections in diabetic patients. Clin Infect Dis 1997; 24(1): 5763.
  • 142
    Jeffcoate WJ, Lipsky BA, Berendt AR, et al. International Working Group on the Diabetic Foot. Unresolved issues in the management of ulcers of the foot in diabetes. Diabet Med 2008; 25(12): 13801389.
  • 143
    Lipsky BA, Baker PD, Landon GC, Fernau R. Antibiotic therapy for diabetic foot infections: comparison of two parenteral-to-oral regimens. Clin Infect Dis. 1997; 24(4): 643648.
  • 144
    Grayson ML, Gibbons GW, Habershaw GM, et al. Use of ampicillin/sulbactam versus imipenem/cilastatin in the treatment of limb-threatening foot infections in diabetic patients. Clin Infect Dis. 1994; 18(5): 683693.
  • 145
    Lipsky BA, Itani K, Norden C. Treating foot infections in diabetic patients: a randomized, multicenter, open-label trial of linezolid versus ampicillin-sulbactam/amoxicillin-clavulanate. Clin Infect Dis. 2004; 38(1): 1724.
  • 146
    Jones V. Debridement of diabetic foot lesions. The Diabetic Foot. 1998; 1: 8894.
  • 147
    Gershater MA, Londahl M, Nyberg P, et al. Complexity of factors related to outcome of neuropathic and neuroischaemic/ischaemic diabetic foot ulcers: a cohort study. Diabetologia 2009; 52(3): 398407.
  • 148
    Venkatesan P, Lawn S, Macfarlane RM, Fletcher EM, Finch RG, Jeffcoate WJ. Conservative management of osteomyelitis in the feet of diabetic patients. Diabet Med. 1997; 14(6): 487490.
  • 149
    Senneville E, Yazdanpanah Y, Cazaubiel M, et al. Rifampicin–ofloxacin oral regimen for the treatment of mild to moderate diabetic foot osteomyelitis. J Antimicrob Chemother. 2001; 48(6): 927930.
  • 150
    Pittet D, Wyssa B, Herter-Clavel C, Kursteiner K, Vaucher J, Lew PD. Outcome of diabetic foot infections treated conservatively: a retrospective cohort study with long-term follow-up. Arch Intern Med. 1999; 159(8): 851856.
  • 151
    Rod-Fleury T, Dunkel N, Assal M, et al. Duration of post-surgical antibiotic therapy for adult chronic osteomyelitis: a single-centre experience. Int Orthop 2011; 35(11): 17251731.
  • 152
    Cruciani M, Lipsky BA, Mengoli C, de Lalla F. Granulocyte-colony stimulating factors as adjunctive therapy for diabetic foot infections. Cochrane Database Syst Rev 2009; (3): CD006810.
  • 153
    Goldman RJ. Hyperbaric oxygen therapy for wound healing and limb salvage: a systematic review. PM R. 2009; 1(5): 471489.
  • 154
    Löndahl M, Katzman P, Nilsson A, Hammarlund C. Hyperbaric oxygen therapy facilitates healing of chronic foot ulcers in patients with diabetes. Diabetes Care. 2010; 33(5): 9981003.
  • 155
    Gupta AK, Uro M, Cooper EA. Onychomycosis therapy: past, present, future. J Drugs Dermatol 2010; 9(9): 11091113.
  • 156
    Aragón-Sánchez J, Quintana-Marrero Y, Lázaro-Martínez JL, et al. Necrotizing soft-tissue infections in the feet of patients with diabetes: outcome of surgical treatment and factors associated with limb loss and mortality. Int J Low Extrem Wounds. 2009; 8(3): 141146.
  • 157
    Aragón-Sánchez FJ, Cabrera-Galván JJ, Quintana-Marrero Y, et al. Outcomes of surgical treatment of diabetic foot osteomyelitis: a series of 185 patients with histopathological confirmation of bone involvement. Diabetologia. 2008; 51(11): 19621970.
  • 158
    Edmonds M. Double trouble: infection and ischemia in the diabetic foot. Int J Low Extrem Wounds 2009; 8(2): 6263.
  • 159
    Gottrup F. Management of the diabetic foot: surgical and organisational aspects. Horm Metab Res 2005; 37(Suppl 1): 6975.
  • 160
    Hauser CJ. Tissue salvage by mapping of skin surface transcutaneous oxygen tension index. Arch Surg 1987; 122(10): 11281130.