Primary prevention

A patient with diabetes mellitus can prevent osteomyelitis by minimising foot trauma and preventing foot ulcers.[20] The patient should be evaluated for ischaemia, with the involvement of multidisciplinary foot teams including podiatrists to improve outcomes.[24]

Provide information about appropriate foot care. Recommend that they check, wash, and moisturise their feet daily to avoid breakages in the skin and to detect wounds early. Advise that patients with vascular or neurological foot problems should avoid activities that might cause unnecessary trauma, including walking barefoot or wearing improperly fitted shoes.[25]

Secondary prevention

For the physician, preventative measures focus on reducing the risks associated with chronic infection.

For the surgeon, debridement, wound irrigation, and muscle-flap or vascularised tissue grafts play major roles in prevention and treatment by removing dead tissue, decreasing bacterial load, and filling dead space with vascularised tissue. Culture-specific antibiotics also play a major role in decreasing the incidence of acute and chronic osteomyelitis. Internal fixation of contaminated dead bone inevitably leads to osteomyelitis and must be avoided.[107]

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