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Abstract：
Although the pathology and bacterial status of the \"normal\" bone stump after operation of diabetic foot osteomyelitis (DFO) are of great significance for the prognosis of foot wounds, there are only a few studies on this topic; hence, it is clinically relevant and urgent to study this topic.
The data of 57 inpatients with DFO from June 2021 to April 2022 were collected, all of whom had DFO in the forefoot and underwent conservative surgery. After the surgical removal of necrotic bone, bone biopsies were taken from the necrotic phalangeal bone and the reserved \"normal\" metatarsal stump. They were cultured, after which antibiotic susceptibility test and pathological screening were carried out. According to clinical judgment, inpatients\' wounds were divided into metatarsal affected group and metatarsal unaffected group. We then compared and analyzed the pathological and bacterial characteristics of preserved \"normal\" bone stump and its effect on wound healing and prognosis.
The poor concordance rate between deep soft tissue culture and infected phalange culture was only 19.3%. The deep soft tissue (72.6%), infected phalange (70.7%), and metatarsal stump (71.4%) were mainly infected with gram-negative Bacillus. The proportion of Enterococcus spp. increased significantly in bone tissue. Acinetobacter baumannii had the highest drug resistance (88%, 22/25). There was no significant difference in several clinical characteristics and wound healing regardless of whether their metatarsal stumps were affected. Most reserved \"normal\" metatarsal stumps (84.2%, 48/57) were positive by pathological diagnosis and bacterial culture testing; only 15.7% (9/57) samples were truly sterile. Only 8.3% (4/48) of the former patients healed within 6 months; whereas, all the latter (9/9) patients healed within 6 months. However, the majority (89.6%, 43/48) could heal. There was no difference in operations, skin grafting, negative pressure wound therapy, and mortality between the two groups.
The most reserved \"normal\" metatarsal stumps have been invaded by bacteria. However, the majority stumps can be preserved, and the wound will eventually be healed according to the pathological and bacterial culture results.
The data of 57 inpatients with DFO from June 2021 to April 2022 were collected, all of whom had DFO in the forefoot and underwent conservative surgery. After the surgical removal of necrotic bone, bone biopsies were taken from the necrotic phalangeal bone and the reserved \"normal\" metatarsal stump. They were cultured, after which antibiotic susceptibility test and pathological screening were carried out. According to clinical judgment, inpatients\' wounds were divided into metatarsal affected group and metatarsal unaffected group. We then compared and analyzed the pathological and bacterial characteristics of preserved \"normal\" bone stump and its effect on wound healing and prognosis.
The poor concordance rate between deep soft tissue culture and infected phalange culture was only 19.3%. The deep soft tissue (72.6%), infected phalange (70.7%), and metatarsal stump (71.4%) were mainly infected with gram-negative Bacillus. The proportion of Enterococcus spp. increased significantly in bone tissue. Acinetobacter baumannii had the highest drug resistance (88%, 22/25). There was no significant difference in several clinical characteristics and wound healing regardless of whether their metatarsal stumps were affected. Most reserved \"normal\" metatarsal stumps (84.2%, 48/57) were positive by pathological diagnosis and bacterial culture testing; only 15.7% (9/57) samples were truly sterile. Only 8.3% (4/48) of the former patients healed within 6 months; whereas, all the latter (9/9) patients healed within 6 months. However, the majority (89.6%, 43/48) could heal. There was no difference in operations, skin grafting, negative pressure wound therapy, and mortality between the two groups.
The most reserved \"normal\" metatarsal stumps have been invaded by bacteria. However, the majority stumps can be preserved, and the wound will eventually be healed according to the pathological and bacterial culture results.
摘要：
■虽然糖尿病足骨髓炎(DFO)术后“正常”骨残端的病理和细菌状态对足部创伤的预后具有重要意义，关于这个主题的研究很少；因此，研究这一课题具有临床意义和紧迫性。
■收集了2021年6月至2022年4月的57例DFO住院患者的数据，所有患者的前足都有DFO，并接受了保守手术。手术切除坏死骨之后,从坏死的指骨和保留的“正常”跖骨残端进行骨活检。他们有教养，之后进行抗生素药敏试验和病理筛查。根据临床判断,住院患者伤口分为跖骨受累组和未受累组。然后，我们比较并分析了保留的“正常”骨残端的病理和细菌特征及其对伤口愈合和预后的影响。
■深层软组织培养与感染指骨培养的一致性差仅为19.3％。深部软组织（72.6%），感染指骨(70.7%)，跖骨残端(71.4%)主要感染革兰氏阴性芽孢杆菌。肠球菌属的比例。在骨组织中显著增加。鲍曼不动杆菌的耐药性最高(88%,22/25).无论其meta骨树桩是否受到影响，几种临床特征和伤口愈合均无显着差异。保留最多的“正常”meta骨树桩（84.2％，48/57）通过病理诊断和细菌培养测试呈阳性；只有15.7％（9/57）的样品是真正无菌的。只有8.3%(4/48)的前患者在6个月内痊愈；然而，后者(9/9)患者均在6个月内痊愈。然而,大多数(89.6%，43/48）可以治愈。在操作上没有区别,植皮,负压伤口治疗,两组之间的死亡率。
■保留最多的“正常”meta骨树桩已被细菌入侵。然而,大多数树桩可以保存，根据病理和细菌培养结果，伤口最终会愈合。
■收集了2021年6月至2022年4月的57例DFO住院患者的数据，所有患者的前足都有DFO，并接受了保守手术。手术切除坏死骨之后,从坏死的指骨和保留的“正常”跖骨残端进行骨活检。他们有教养，之后进行抗生素药敏试验和病理筛查。根据临床判断,住院患者伤口分为跖骨受累组和未受累组。然后，我们比较并分析了保留的“正常”骨残端的病理和细菌特征及其对伤口愈合和预后的影响。
■深层软组织培养与感染指骨培养的一致性差仅为19.3％。深部软组织（72.6%），感染指骨(70.7%)，跖骨残端(71.4%)主要感染革兰氏阴性芽孢杆菌。肠球菌属的比例。在骨组织中显著增加。鲍曼不动杆菌的耐药性最高(88%,22/25).无论其meta骨树桩是否受到影响，几种临床特征和伤口愈合均无显着差异。保留最多的“正常”meta骨树桩（84.2％，48/57）通过病理诊断和细菌培养测试呈阳性；只有15.7％（9/57）的样品是真正无菌的。只有8.3%(4/48)的前患者在6个月内痊愈；然而，后者(9/9)患者均在6个月内痊愈。然而,大多数(89.6%，43/48）可以治愈。在操作上没有区别,植皮,负压伤口治疗,两组之间的死亡率。
■保留最多的“正常”meta骨树桩已被细菌入侵。然而,大多数树桩可以保存，根据病理和细菌培养结果，伤口最终会愈合。
