Bioactive glass, a new tool for the treatment in the diabetic foot recalcitrant osteomyelitis: A case series with 24-month follow-up.

Abstract

BACKGROUND\nThe bioactive glass (BAG) is a promising solution for the reconstruction of bone defects and the eradication of infection in patients with osteomyelitis, however references to the treatment of diabetic foot osteomyelitis are scarce in the literature.\n\n\nMETHODS\nOur experience in patients with diabetic foot osteomyelitis, who required surgical debridement and void filling, in which we use bioactive glass (n = 6), was evaluated. During a minimum follow-up of 24 months, the presence of persistent infection and healing rate, post-surgical complications, surgical reinterventions, degree of osseointegration and BAG-related side effects was analyzed.\n\n\nRESULTS\nAt the end of the follow-up, none of the patients showed signs of persistent infection and the healing rate was 66.6% (4/6). Postoperative complications were noted in 3 patients and two of the them required new surgical intervention, both due to skin coverage or vascular complications. A complete osseointegration in the 66.6% of the patients and no cases of local adverse effects were recorded.\n\n\nCONCLUSIONS\nThe bioactive glass can be a useful tool in the treatment of certain cases of diabetic foot osteomyelitis, provided that a multidisciplinary approach and strict patient selection is in place.\n\n\nLEVEL OF EVIDENCE\nIV.