Controlling Osteomyelitis — Bone Infection — to Prevent Amputation

As the millions of people who are living with diabetes can attest, letting your guard down can lead to serious complications. In this case, we’re referring to lower limb amputation — each year in the United States, about 130,000 people with diabetes undergo an amputation.

These amputations are largely driven by a common complication of diabetic foot ulcers — osteomyelitis — which is an infection in your bone.

At our practice, Foot Ankle Leg Wound Care Orange County, one of Dr. Thomas Rambacher’s overarching goals is to do everything possible to prevent amputation. Here’s a look at how we address osteomyelitis to minimize tissue loss.

How the infection gets bone deep

The road to osteomyelitis starts with a foot wound or ulcer, which are incredibly common among people with diabetes — between 15% and 25% of diabetics develop a foot ulcer at some point during their lives.

Of these foot ulcers, approximately 60% are complicated by infection — and this infection travels to the bone in 10%-15% of moderate infections and 50% of severe infections. 

The pathway to osteomyelitis usually starts with an ulcer that is slow to heal, which weakens the defenses around the ulcer. This allows bacteria or fungi to make their way inside the ulcer and then gain access to your bone marrow, where they colonize. 

Once inside, the bone infection can lead to inflammation in the marrow, which cuts off the blood supply to the area. When this happens, bone tissue can start to die off and the infection can spread to other bones, sometimes forcing amputation.

Stopping the bone infection

As we mentioned, our goal is to successfully intervene before there’s tissue loss (necrosis) due to the infection.

If we identify through X-rays that osteomyelitis has taken hold, we start you on a strong course of antibiotics to help fight off the infection. As you might imagine, the earlier we can get the antibiotics into your system, the better.

Antibiotics are also more successful if the ulcer is small and located near the front of your foot — mid and hind foot infections can be tougher to treat, but we will still try antibiotics first.

While you’re taking antibiotics, we do everything possible to encourage healing in your ulcer, whether it’s through cleaning and debridement, as well as offloading (taking the pressure off of the ulcer). These steps are as important as the antibiotics in creating a healthier environment in your foot to help fight off the infection.

If the antibiotics fall short, we can go in and remove the affected bone tissue — a procedure called foot and limb salvage — to prevent the osteomyelitis from traveling to other bones in your lower limb.

It’s impossible to say here exactly what your treatment for osteomyelitis might look like as we have to thoroughly evaluate the extent of the infection first. Rest assured, we do everything in our power to prevent tissue loss, but you need to do your part by coming to see us at the very first signs of a problem in your foot.

If you have more questions about osteomyelitis, please don’t hesitate to call our office in Mission Viejo, California, at 949-832-6018 or request an appointment online today.