Abstract：
Obtaining clean margins in patients who undergo surgical treatment for diabetic foot osteomyelitis (DFO) is recommended. We hypothesize that the rate of recurrence of the infection is not associated with positive margins, even when using a short-term duration of postoperative antibiotic treatment. We conducted a retrospective pilot study of patients who underwent surgery for DFO confirmed by histopathological analysis of the resected bone from August 1, 2020, to December 1, 2020. Bone samples were taken from the proximal margins to be studied by microbiology and histopathology. Twenty-five (89.3%) patients underwent conservative surgery, and 3 (10.7%) patients underwent a minor amputation. After surgery, the antibiotics were stopped in 19 (67.9%) patients and continued in 9 (32.1%) patients for a median period of 4 days. The microbiology of the bone margins was positive in 20 (71.4%) cases, but the histopathology of the bone margins was positive in just 7 (25%) cases. Recurrence of the infection was detected in 3 (10.7%) patients. Seventeen (68%) patients with microbiological-positive margins did not have a recurrence of infection, while 3 (100%) patients had a recurrence of infection (P = .53). Six (24%) patients among those with histopathological-positive margins did not have a recurrence of infection, and1 (33.3%) patient had a recurrence of infection (P = 1). The recurrence of infection was low and always detected in soft tissues, including the cases with a histopathological-positive bone margin. Postoperative antibiotics were administered for a short period of time and not based on the analysis of bone margins.
摘要：
建议在接受糖尿病足骨髓炎（DFO）手术治疗的患者中获得清洁的边缘。我们假设感染的复发率与阳性切缘无关，即使使用短期的术后抗生素治疗。我们对从2020年8月1日至2020年12月1日接受DFO手术的患者进行了回顾性试点研究，这些患者通过对切除的骨进行组织病理学分析证实。从近端边缘采集骨样本，进行微生物学和组织病理学研究。25例(89.3%)患者接受保守手术,3例(10.7%)患者接受了轻微截肢。手术后,19例(67.9%)患者停用抗生素,9例(32.1%)患者继续使用抗生素,中位时间为4天.20例(71.4%)骨缘微生物学阳性,但仅有7例(25%)的骨缘组织病理学呈阳性。3例(10.7%)患者感染复发。17例（68%）微生物切缘阳性的患者没有感染复发，而3例(100%)患者感染复发(P=.53)。组织病理学边缘阳性的患者中有6例（24％）没有感染复发，1例(33.3%)患者感染复发(P=1)。感染的复发率很低，并且总是在软组织中检测到，包括骨缘组织病理学阳性的病例。术后抗生素的使用时间较短，而不是基于对骨缘的分析。
