Clinical care and other categories posters: Foot

Abstract

Aim: This study aimed to determine if there was an association between the type of foot ulceration and the management of osteomyelitis complicating diabetes foot ulceration (DFU). Methods: This was an observational study of 1006 episodes who presented to the multidisciplinary diabetic foot clinic between December 2017 and September 2019. Data collected included the type of foot ulceration, complications, and management outcomes. Results: 180/1006 episodes had diabetic foot osteomyelitis, in which 80/180 episodes had a neuropathic ulcer, 12/180 episodes had an ischaemic ulcer, and 88/180 episodes had a neuroischaemic ulcer. Among episodes of osteomyelitis with neuropathic ulceration, 72.5% of episodes resolved with antibiotics with 2 episodes requiring angioplasty. Of those who had received antibiotics, 26/80 episodes resolved with oral antibiotics alone. 26.3% of episodes required surgical orthopaedic intervention {minor amputation (n = 17), major amputation (n = 1) and debridement (n = 3)}. Among episodes of osteomyelitis with ischaemic ulceration, 66.7% of episodes resolved with antibiotics with 5 episodes requiring angioplasty. 25% of episodes required surgical orthopaedic intervention {(minor amputation n = 2) and major amputation (n = 1)}. Among episodes of osteomyelitis with neuroischaemic ulceration, 59.1% of episodes resolved with antibiotics with 10 episodes requiring angioplasty and 1 episode requiring lower limb arterial bypass. 29.5% of episodes required surgical orthopaedic intervention {minor amputation (n = 21), major amputation (n = 4) and debridement (n = 1)}. Conclusion: Osteomyelitis occurring as a complication of neuropathic foot ulceration is more likely to resolve with antibiotics than osteomyelitis resulting from ischaemic or neuroischaemic ulcers. Osteomyelitis associated with neuroischaemic ulceration is more likely to require surgical intervention. P189 | Characteristics of patients with future diabetic foot ulceration: Can those be used to predict ulceration incident?