Primary prevention
Patients with diabetes mellitus can prevent osteomyelitis by minimizing foot trauma and by preventing foot ulcers.[34][36] They should be evaluated for ischemia, with the involvement of multidisciplinary foot teams such as podiatry to improve outcomes.[36][37][42]
Patients should be educated about proper foot care, including daily inspection of the feet.[36] Daily foot washing and use of moisturizing creams are necessary to avoid breakages in the skin. Furthermore, patients should avoid activities that might cause unnecessary trauma to vasculitic neuropathic feet. This includes walking barefoot or wearing improperly fitted shoes.[43]
Secondary prevention
For the physician, preventative measures focus on reducing the chance that the chronic form of the infection will develop. Surgical debridement, wound irrigation, and muscle-flap or vascularized tissue grafts play major roles in prevention and treatment by removing dead tissue, decreasing bacterial load, and filling dead space with vascularized 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.[142]
Use of this content is subject to our disclaimer